Wiki Place of service audit


Shirley, MA
Best answers
Good morning,

I'm processing an audit response, the focus of which is place of service. The auditor is requesting documentation to support that the services billed were billed for POS 11 were indeed delivered at POS 11. We are a privately owned, physician-based office, and truthfully, I've never had to think about how I would support that assertion. Can anyone point me in a direction for how I would begin to gather supporting documentation that we are not a facility?

Thanks in advance for your knowledge.
POS Audit

I was advised by an auditor at Novitas-Solutions during one of our audits that it is acceptable to submit a screen print out of your scheduling software for that component. It must show of course, the address where the service was rendered, appointment status (arrived, departed) and the patients name & appointment time. Hope this helps.;)

Do your physicians go anywhere else to provide services? For example, do they perform services in an in- or outpatient hospital setting? Or on a specific floor of a hospital (inpatient rehab, psychiatric, etc.). Do they see patients in private homes, nursing facilities, or in rural health or federally qualified health centers?

As a compliance auditor, it sounds to me like claims were possibly processed for non-office areas and that alerted the payor that the physicians may be providing services outside of the office, but billed with office POS. Remember, the place of service is regarding the patient's location not the practitioner's specialty or services rendered.