Physician Auditing

Under Coding or Incorrect Coding Can Cost You Valuable Income!!		ARE YOU COMPLIANT WITH YOUR PHYSICIAN AUDITS?
FACT If you under code 2 encounters or more per week, you could be losing $10,000 or more income per year!!! CORRECT CODING BENEFITS Clean claims Fewer appeals Increased income Decreased chances of Medicare fraud. RISKS OF UNDER CODING According to AMA, if a practice under codes a procedure for one Medicare patient, the procedures that were coded at a higher level could be deemed Medicare fraud....so under coding as a precaution does not help.		OIG RECOMMENDATIONS Education and training programs for physicians Five or more medical records per federal payer or five to ten medical records per physician Establish practice standards and procedures for dealing with practice risk areas of non-compliant physicians RISKS OF OVER CODING CConsequences for over coding could include possible refunds or fines and charges of fraud and abuse. The fines are usually $10,000 per occurrence. Auditors will not stop at one occurrence.

ALL PHYSICIANS CAN INCREASE THEIR REIMBURSEMENTS BY CHANGING SOME OF THEIR CODING HABITS

You can charge for a higher level of service by documenting time without a complete exam or review of systems
You can charge closure codes on excisions and incisions. A 2.5 cm layered closure can increase this visit by $200 - $300!
Using E codes with injuries and fractures can speed up the claim process to get your money more quickly