Conducting A Charge Audit to Increase Revenue + Best Practices for Physician Auditing – Combo

Conducting A Charge Audit to Increase Revenue

Areas Covered

• A major component of successful revenue management is accurate charging for services provided. Charges must be identified, posted timely and completely.
• Hospital charge capture is typically handled by the department that provided the service. Professional charges may be posted by the provider. In either case, the function may be a low administrative priority with little to limited training for charging activities. Coordination between departments may not be established. Accountability for correct charging may be minimal.
• There may be no formal policies or baseline controls for correct charge capture.
• Different systems may be used for charging and reconciliation

An effective charge audit can identify lost revenue opportunities

Webinar’s Goals

• Understand the importance of accurate charge capture
• Tips for charge review
• Departmental charge capture errors & omissions
• Revenue leakage resulting from charging errors
• Reduce non-compliance exposure
• Improvement of operational efficiency
• Enhance patient satisfaction

Key Points

• Why Errors Occur
• Multiple departments entering charges
• Charge master may be incorrect or incomplete
• Error in number of units selected
• Error in item selection
• Inactive charge
• New service not added
• Incorrect revenue code/cost center
• System conversions
• Overreliance on claims scrubber

Target Audience

• Physicians
• Practice managers
• Medical assistants
• Nurses
• Compliance staff
• Billers
• Coders
• Revenue Cycle
• Risk Management

Best Practices for Physician Auditing

Is your practice audit safe? Do you have compliance risks? The first issue will be where do you start to determine your risk. Some key questions to ask: Is this a compliance or educational audit? Is this a baseline audit or a more focused audit? Do you have an internal audit team or do you need to hire external auditors? The type of audit will determine where to start, how many services to review and the type of service(s) to be audited. Is there a time limitation? Has there been a previous audit that showed issues that need attention? Have there been internal or external complaints that need to be reviewed? This webinar will discuss best practices and all of these issues as well as how to determine a pull and how many services should be included in the audit.

Webinar Objectives

• How to determine the scope/sample of the audit
• Government suggestions for auditing.
• The difference between a concurrent versus retrospective audit.
• What is the difference in an educational audit and a compliance audit
• What is an attorney client privilege audit.
• How does the type of practice change the audit focus.
• What are the risk areas depending on the type of physician practice.

Webinar Highlights

• Auditing for office services
• Incomplete documentation for office ancillary services such as injections, cerumen impaction removal, nebulizer treatments etc
• “Incident to”
• Initial, subsequent hospital and observation services.
  • Shared care
• Auditing for surgical and specialty practices
• Modifier usage

Who Should Attend

• Office managers
• Compliance team and officers
• Coders
• Providers
• Denial management staff