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Audit workflow and policies

  1. #1
    Default Audit workflow and policies
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    Do any of you have a policy in place that states the person that audit/codes a visit can not be the person to key it? Or if someone removes a code/invoice they can not be the one that rekeys the correct code?

    I have always been able to do all functions previously and it just strikes me as odd that since we went with a new billing service they have placed these restrictions on us. It really impedes our workflow.

    An example would be if I'm auditing a visit and everything is correct but they forgot to put a modifier on one of the codes. Previously I would add the modifier and drop the claim. Now, I have to write up the correction and give it to someone else to do. If I change the code completely, it has to be written up given to someone to delete, then they have to give it to someone else to rekey. So it takes 3 people and sometimes multiple days to do what used to be a 2 minute or less correction.

    This just seems absurd to me and I was wondering if I am out of touch with reality and this is how it is done in most places.


    Laura, CPC, CPMA, CEMC

  2. #2
    Evansville Indiana
    Default re-keying
    I think it is absurd too. I have worked in several types of businesses, billing company, surgery center, hospital, and have never had these restrictions. It sounds like internal controls gone "mad" to me.

  3. #3
    Medical Billing
    I do not have a access for billing issues. Yes I change codes and give it to that staff depending on the insurance. We have assigned staff for each insurance

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