How To Deal With Auditing Issues In Cardiology Documentation?

Auditing season is heating up; cardiology practices with documentation concerns are contacting medical auditors to review their clinical documentation improvement (CDI) policies so they are secure in their practices to avoid documentation issues that can lead to negative payer audits.

In medical practices, it is so important to have coders, billers, and knowledgeable clinical staff to help close the gap between errors. Especially in larger practices where compliance can sometimes be at issue, it is highly recommended to self-audit first, internally, with qualified staff.

Sure, it can be costly, but how much more cost would you incur if you’re audited and have to pay back not just money paid to you, but fees added on for the error? Not only that once you are formally audited by a payer, you now have a target on your back. They may continue to watch you’re coding and billing habits for a long time.

Enlisting certified coders and/or accredited billers has been known to be protective of your practice and your physicians’ because they are protecting their reputation as well. It’s something to think about as you look at the current auditing climate, or if you are considering an external audit of documentation as well.

Physicians from smaller practices may think that they won’t get audited but that might not be the case.

New regulations can be a burdensome and sometimes even impossible task to implement. Without them, they’re costing your cardiology practice more than you realize unless you have the right cardiology revenue cycle management company that specializes in cardiology auditing and compliance regulations.

Benefits Of Medical Audits In Cardiology Documentation:

  • Determine Outliers Before Large Payers Find Them In Their Claims Software And Request An Internal Audit Be Done
  • Protect Against Fraudulent Claims And Billing Activity
  • Reveal Whether There Is Variation From National Averages Due To Inappropriate Coding, Insufficient Documentation, Or Lost Revenue
  • Help Identify And Correct Problem Areas Before Insurance Or Government Payers Challenge Inappropriate Coding
  • Remedy Under Coding, Bad Unbundling Habits, And Code Overuse And To Bill Appropriately For Documented Procedures
  • Identify Reimbursement Deficiencies And Opportunities For Appropriate Reimbursement
  • Stop The Use Of Outdated Or Incorrect Codes For Procedures

Having a professional medical billing service can help cardiology practices and groups meet government regulations, private payer requirements, and the challenges of running the business. Their solutions are focused on helping your office manage claim filing efficiently, and avoid hassles of denial management, HIPAA compliance, and follow-ups with insurance companies.

  • Demographic Entry
  • Patient Scheduling And Charge Entry
  • Insurance Authorization And Verification
  • Code Checking And Analysis
  • Payment Posting Services
  • Claims Billing And Patient Billing Transmission
  • AR Follow-Up
  • Collections Management
  • Billing And Reconciliation Of Accounts

Cardiology practice is a tedious affair because of its intricate nature. Cardiology practitioners spend a great deal of time and resources adhering to regulations around the administrative paperwork. Lately introduced ICD-10, detailed documentation practices, new coding, and billing practices can impact the physician’s revenue cycle and account receivables significantly.

Auditing can help overcome the above-mentioned problems. There are many benefits that an audit brings with it. No matter whether internal or external, an audit does not only bring out common coding and documentation errors but also helps to identify needs for further training of staff. Proper attention to detailed documentation, attentive coding ensures a faster return in the revenue cycle, decrease external audits, and overall improved compliance.