Medical Auditing for Health Care Facilities and Physician practices is a key to being compliant and profitable. Hospitals reported $167 Million by Recovery Audit Contractors (RACs). We can help your practice make sure your documentation includes the correct  modifiers, evaluation and management  codes and procedures that support medical necessity.

Benefits of An Audit by Precision HealthCare Consultants

1. Discover and take action against  coding and billing errors to prevent governmental investigational auditors, like Recovery Audit Contractors (RACs)
2. Help protect your practice against fraudulent claims and non compliant billing activity.
3. Uncover and remedy under-coding and money left on the table!
4. Identify and correct instances of inappropriate billing of services appropriately provided and documented.
5. Diagnose  reimbursement deficiencies and opportunities for appropriate reimbursement.
6. Eradicate the use of outdated or incorrect codes for CPT Codes/procedures.
7. Decipher and eliminate unbundling  and over utilization of codes, which can lead to  audits.

Scope of Work for Providing Audit For Your Facility/Practice

Package #1 – Starter Audit – (3 Case/Encounter Review) $449

Package #2 – Pro Audit – (5 Case/Encounter Review)   $699

Package #3 – Executive Audit (10 Case/Encounter Review) $999

Custom Package – Let’s Talk to Customize Package for Your Practice – Call us @ 516-771-7554

All Packages Include The Below Scope of Work:

1. Defining the scope of your audit – Number of Cases and Insurance Carriers.
2. Utilize the following  reference materials:
   • Current editions of coding manuals
   • National Correct Coding Initiative (CCI) edits
   • Center for Medicare & Medicaid Services (CMS) policies and/or other third-party policies.
3. Verifying the accuracy of billed services by obtaining copies of electronic or paper  claim forms and encounters
4. Validation of:
   • CPT® code use
   • Level of E/M visit
   • Review of under-documented or undocumented services
   •  Correct modifier usage
   • Accuracy of diagnosis codes
   • Source documents supports medical necessity.
5. Review of basic compliance items:
   • signatures and authentications of physicians and/or providers
   • patient identifying information
   • incident-to requirements compliance
6. Prepared  summary of findings and recommendations
7. Scheduling meetings  with the physicians and/or office administrator  to review and provide findings along with recommendations for optimal reimbursement
8. Suggest/Propose training along with  process to monitor the identified areas after addressing the issues.

Our team of  AHIMA and AAPC Certified Inpatient, Outpatient, Evaluation & Management and Procedure Coders and Auditors have helped doctors and facilities ensure compliance and identify any areas of clinical documentation deficiencies along with potential reimbursement under-coding where money is left on the table.

Our Auditors are certified with AHIMA and AAPC to provide the following services:

• Insurance audit appeals
• Coding and billing accuracy
• Accounts receivable audits
• Compliance audits
• ICD-10 compliance with our AHIMA ICD-10 Certified Trainers

Let’s Talk and Get Started call us @ 516-771-7554 or complete below