Consistent internal audits are an essential function for recalibrating coding teams as workload pressures and interdepartmental communication can slowly steer things off track. But external audits should be sought out quarterly or annually, as well. External auditors can contribute fresh feedback to your coding and documentation efforts because it is unbiased and sourced from professionals with unique skillsets. HCM’s coding team approaches audits from three main perspectives.
Operational
Examining how and when coding is being performed during the patient journey.
Quality
Measuring accuracy based on the story being told in physician documentation
Compliance
Verifying that documentation and codes are meeting the latest CMS guidelines.
Our team can approach audits in the following ways:
Updating information with payers
Preventing denials or delays by checking for errors
Consistent timely outreach to payers to obtain provider participation