Hi, I need assistance with the following scenario?
Scenerio:
Records were requested for a professional audit on ED/OBS and inpatient claims. The provider sends the facility documentation (anywhere from 10-20 pages long for each record) and ask that we sift through to find the professional e/m and signature for the provider we are auditing. Wouldn't it be appropriate to cite them for "insufficient documentation" or "illegible documentation" and ask them to please submit the professional documentation rather than the facility's, as the time it would take to perform such a task and try and authenticate that the e/m was performed by the provider being audited and not one of the many other physicians who saw the patient during patient's stay? Are there any audit guidelines to address a situation such as this?
I appreciate any assistance...Thank you!
Ellen K.
Scenerio:
Records were requested for a professional audit on ED/OBS and inpatient claims. The provider sends the facility documentation (anywhere from 10-20 pages long for each record) and ask that we sift through to find the professional e/m and signature for the provider we are auditing. Wouldn't it be appropriate to cite them for "insufficient documentation" or "illegible documentation" and ask them to please submit the professional documentation rather than the facility's, as the time it would take to perform such a task and try and authenticate that the e/m was performed by the provider being audited and not one of the many other physicians who saw the patient during patient's stay? Are there any audit guidelines to address a situation such as this?
I appreciate any assistance...Thank you!
Ellen K.