Are you prepared for a Medicare, Medicaid or Private Payor Audit? At some point, you most likely will be the focus of one of the following audits:

• Prepayment Audit.
• Postpayment Audit.
• Comprehensive Audit.
• Procedure Focused Audit.

Physicians are now the focus of increasing and intense scrutiny - not by just Medicare and Medicaid, but by the entire health insurance industry. Every claim sent to all types of insurance plans must be accurate and complete, or if reviewed, it could present a major problem and result in costly civil penalties.

Your local carrier and private payors review your claims and practice patterns, and compare your data to national and specialty specific statistics. You could be flagged for a review if your profile differs from medically recognized norms.

Did you know that insufficient documentation is the most frequent reason for a Medicare denial of payment?

Our experienced auditors are Certified Professional Coders (CPC's) and Certified Compliance Professionals (CCP's) with years of experience in billing and coding. They use the Medicare Evaluation and Management Documentation Guidelines to ensure your progress notes demonstrate that the level of service is appropriate, the tests you order are medically necessary, and the diagnosis matches the procedures.

Find out if your charts can withstand a Medicare or payor review. Call our Healthcare Advisory professionals at Kerkering Barberio for a private critique. Let us take a look before CMS does. We offer:

• E/M coding and documentation analysis.
• Investigation of "red flags."
• Comparative Utilization Analysis.
• Corrective action plans.
• Ongoing education. 
  

Minimize your audit risk and ensure appropriate reimbursement.

An internal chart audit will identify areas where your documentation may be lacking and could be putting your practice at risk for an audit and repayment to a carrier. Our audits also frequently uncover missed services and under-coding which may be costing your practice revenue. Make sure you have adequate and accurate documentation to support claimed services, procedure codes, and level of service. Call us for a confidential chart analysis.

Even if you are already being audited or preparing for an appeal, we can help.