Has your practice conducted baseline and subsequent medical record documentation and coding reviews? Have you considered establishing a peer-review committee for addressing documentation or coding problems if they exist?
Is coding education offered to all physicians and appropriate employees of the practice?
Hopefully the answer is “yes” because practices that perform regular audits are more compliant with all billing standards, coding guidelines, and federal rules and regulations (eg, Health Insurance Portability and Accountability Act, Antikickback Act, False Claims Act). Federal rules and regulations can be accessed at www.hhs.gov or www.oig.hhs.gov.
If the answer to these questions is “no,” the following basic principles should provide you with some direction and guidance to help you get started.
Determine who will perform the audit. Will it be a physician, a physician extender, a coder or other administrative employee, an outside consultant, or a combination? Any of these would be a good choice,...