Wiki chart and payment auditing

[tlwhlw]

I have been asked by a doctor in the area whom I used to work for to perform an audit on his charts, charges, and payments received by insurance. He is questioning what/how his current coder/biller is doing.

I just want to make sure I look at everything possible such as: documentation vs charges entered, fee schedules, EOB's, etc. What else could I possibly need to review???

Also, what does a CPC charge for doing an audit like this? I've never done this before; didn't know if I should charge by the hour or a flat rate. Any suggestions???

Thank you,
Tracy, CPC

 

[mcandia]

Chart and payment auditing

Be sure to pull all charge tickets / encounter forms and pay particular attention to claims that have been denied and why.


You are performing an external audit so $25 - $30 per hour is appropriate. If the physician had to hire an outside consulting firm it would cost much more.

Maria Candia CPC, CPC-H, CEMC

 

[tlwhlw]

Thank you!!!!!