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Charges for chart auditing

  1. #1
    Default Charges for chart auditing
    Medical Coding Books
    Can anyone give me the going per chart rate for auditing. Is it different for hospital audits vs physician practice audits? I'm trying to develop my pricing and would appreciate any information you could share. Thanks.

    T Smith, CPC, CPC-H, CPC-I, CHCA, CGCS

  2. #2
    I would suggest you do some research on the type of services you want to audit. There are a lot of companies, mostly billing companies, that offer "chart auditing" services. Their prices are all over the place.

    I have a quotes from 2 different companies that charges $100 per surgical case or E/M service audited.

    I have another that is $50 per E/M and $65 per surgical case.

    I have one company that charges $12 an encounter regardless of what specialty or what the service was. Meaning if it is a no charge surgery follow-up and they look at it you still pay $12.

    Another one is priced per day of stay in the hospital. I think the base was $7.50 for 1-10 days and then it went up day to day but we never utilized this so I don't recall.

    I will say that even though you may be paying more for some of the serivces doesn't mean you get more. Of the above companies listed the one that charges $50-65 is the only one that I trust.

    Hope this was somewhat helpful,

    Laura, CPC

  3. #3
    Default What about this....
    I have a similar question. The above response was helpful, but I'm wondering if it would be different for my scenario.
    I do internal E/M audits for office, hospital and nursing home visits for a multi-physician family practice clinic. If I were to charge my employer for each visit audited, what would be an appropriate amount to charge for each audit?
    Carrie, BS, CPC

  4. #4
    Is that not part of your normal job? I doubt you will get any additional money out of your employer if you already do that function. If this is something new they are adding to you I would try and negotiate a pay raise. If they are wanting to use your auditing services like they would an outside consultant, I would come up with a fee schedule and bill them per service audited as if you weren't an employee.

    I am an internal coding auditor and educator so I just get my hourly rate regardless of what I am doing. Be it auditing, teaching, or front end coding.

    Good luck,

    Laura, CPC

  5. #5
    I work for a practice management firm as a consultant. On top of my base salary, I get 40% profit from the revenue I generate as incentive. Whether it be auditing, educational seminars, etc.

    Fees for those services are based on their needs, I calculate time, overhead, etc. Auditing services can start from $500 and my biggest one was $15,000. Depending on how many charts, providers, how often the audits are, etc... I draw up the proposals based on flat per chart rates or hourly... it really just depends on the client and their needs. You need to take it client by client and be reasonable, yet competitive. In the beginning I didn't make one red cent, sometimes you have to charge less to get more.
    Last edited by ARCPC9491; 07-08-2009 at 07:49 AM.

  6. Default Charges for chart auditing
    It's also worth considering what the report will look like. Is it machine generated, or does it have commentary from the auditor, specific to that clinician. When I do audits, I also like to have the E/M profile of the clinician in front of me, (along with the norm for the specialty) and include a comment about that in the report.

    For example, if I see a doctor who bills 80% 99214's for established patients, and none of the 99214's meet the criteria, the profile knowledge increases everyone's attention!
    Betsy Nicoletti, M.S., CPC

  7. Smile
    I am working on a new proposal for Auditing a multi-physician/surgeons' practice. I usually go into a practice and work there for 3 - 6 months and clean up everything form front office to back office. These practices I usually go to are in BIG trouble before I get there, bounced payroll checks, going bankrupt, staff stealing for years.. so I am used to that. This practice says they are doing well but they just want to be sure they are billing as efficiently as possible. I am always able to turn the practice around if they take my advice. The only ones that don't, are the ones who won't change their and their staff's bad habits. Since I always done a long term contract this one is different. I figured I estimate the number of hours needed than do an hourly fee as suggested above ... but I wonder about the format used for the proposal. My email is if any one has a sample of a proposal they wouldn't mind sharing. Thanks.

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