One of the biggest financial burdens on any medical practice is that of medical audit. Even though it is a necessary evil in the healthcare industry, medical audits setback the financial growth of any practice and initiates change in an otherwise streamlined medical practice. The best way to prepare your chiropractic clinic for a medical audit is by eliminating any chances of audit altogether. Most medical audits originate due to billing failures, repeated claim denials and customer complains. All these issues can be effectively captured in the billing processes and can be easily fixed.
Commonly found chiropractic medical billing errors that lead to an increased audit risk are –
- Allocation of incorrect ICD9, ICD10 or CPT codes for services rendered
- Providing all services at one level and billing all services at a higher level
- Recording incorrect services in patient data
- Non compliance to HIPAA guidelines for patient record maintenance and transfer
Now these errors can be easily captured and fixed by taking the following steps –
- Install revenue cycle management or RCM in your chiropractic billing: RCM is a holistic approach towards streamlining your coding and billing processes. With the daily, weekly and monthly reports generated by RCM you can check the billing cycle, claim cycle and collections cycle effectively. RCM also facilitates your supervision by generating meaningful analysis of your billing processes that can in turn be referred to for making system improvements.
- Monitor billing procedures regularly to identify chronic and one-time errors: Most billing errors that can attract a medical audit are result of negligence or process inadequacy and can be avoided in long run. On the other hand, there are some very common coding related errors which remain unnoticed in the system until caught by an insurance carrier. Therefore, these chronic as well as one time errors must be addressed by way of medical staff training, regular coding revisions in the system and even monitoring automatic duplication of codes.
- Track causes of claim denials in your system: Claim denials and rejections on grounds of non compliance, coding or documentation are red flags for your chiropractic billing process and can attract audit at any time. Therefore, you must do a root cause analysis of each and every claim denial instead of simply getting your medical billing service provider to file an appeal or foregoing the revenue from that claim.
- Address causes of customer complaints: Repeated customer complaints on incorrect diagnosis or insufficient treatment yet excessive billing can also increase the audit risk for your chiropractic clinic. Thus you must install a proper system in you billing process that should capture as well as address gaps in the system.
Medicalbillersandcoders.com is specialty billing service provider that offers the service of hundreds of medical billers and coders from the field of chiropractic. We not only understand the underlying failures of a billing process that can attract an audit but can also help you reduce potential audit risk by streamlining your billing processes effectively.