Preparing your Neurology Billing for Medicare Audits

June 23, 2014

Neurology billing, like any other specialty care, requires highly customized and specific process monitoring in order to reduce coding errors, rate of claim denials and to improve revenue cycle management. In addition to that, it is at an all time high risk of Medicare audits as the impending ICD 10 changes are going to completely transform the way neurology coding and billing happens. Moreover the government has released a budget of $250 million for various enforcement agencies to detect, track and remedy healthcare fraud. Therefore, it is the right time to prepare your neurology practice for Medicare audits to prevent any operational and financial losses. With the RAC program estimating that 3.9 percent of Medicare payments in the past three years have been overpayments, Medicare audits will be done with the only motive of retrieving those overspent dollars.

You can, however, prepare your neurology practice for Medicare audits well in advance. The first step towards effective Medicare audit preparation is to set up a dedicated team who can manage your audit related communications and negotiations. Following steps can make you audit-ready at a moment’s notice, if applied well in advance -

  • Make your Neurosurgeon team aware of the RAC and audit process
    The biggest roadblock that your neurosurgeon practice may face is that your team can refuse complete support to the audit process thinking the liability to be insignificant. That is why it is imperative to inform your team about the significance of RAC, Medicare audits and its potential impact on your practice. It can in turn improve the receptivity of your team towards audit related queries and processes.
  • Keep a track of all the denied claims on grounds of coding errors
    Most Medicare audits are initiated in response to a denied or rejected claim that may have resulted in customer complaints. Therefore, a major preparatory and precautionary measure for your neurology practice should be, documenting all rejected claims and appeal processes that were ever initiated for the same.
  • Automate all your previous medical records One of the major reasons of audits taking an awry turn is the inability of medical practices to produce required documents and patient records on time. Automation of all previous records can save a lot of process struggle and make extraction of required records relatively easy.
  • Establish a TAT for audit related queries Your neurology practice may be operating like a well oiled machine as far as normal operations are concerned, but if you are not able to revert to audit related queries within a desired turn-around time you can end up complicating the process for yourself. Thus, it is important to install pre-defined TAT in the system for audits.
  • Adhere to HIPAA compliance at the time of sharing patient data
    Even at the time of an audit your medical team must practice discretion with patient data and share only the required information with auditors as per HIPAA guidelines.

MedicalBillersandCoders.com can prove to be an invaluable coding and billing support for your neurology practice in the event of a Medicare audit. Our billing software can automate your patient records, track your settled and denied claims, establish TAT for audit queries and provide domain specific expertise from medical consultants to handle audits.


Category : Best Billing and Coding Practices