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Department of Audit Support and Compliance Services

 

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THE NEED

With the countless challenges that impact healthcare providers today, it has never been more important to properly and sufficiently document to satisfy reporting requirements for the E&M visits, procedures, supplies and other medical and ancillary services that your organization provides.

HOW WE HELP

The Association for Rural & Community Health Professional Coding (ArchProCoding) performs thousands of documentation and coding reviews each year. The reviews we perform encompass Evaluation and Management (E&M) services and the other applicable aspects of coding and billing for providers in Rural Health Clinics (RHCs), Community Health (FQHCs), Critical Access Hospitals (CAHs).  Arch Pro Coding offers a number of audit strategies based on the individual client’s situational needs. John F. Burns is a dual-certified coder and auditor (CPC, CEMC, CPC-I, CPMA) who brings nearly 25 years of diverse experience to the table and is well suited to handle reviews of all sizes and nearly every specialty. 

WHAT WE DO

The typical audit/review process for each provider we review includes an encounter selection process (10-20 encounters typically selected for each provider). We suggest a sample reflecting a wide array of services (e.g., new patients, established patients, preventive, etc.). Documentation for each case will be carefully considered as described below:

  • Even for categories of E&M requiring that only 2 of 3 “key components” (e.g., established patient outpatient visits 99212-99215) are required, reviews will be performed assuming that Medical Decision Making must be one (1) of the required
    documentation elements
  • The accuracy of CPT/HCPCS II modifiers (e.g., -25, -59, -CG, etc.), where applicable, and
  • The accuracy, specificity and assignment of principle and other supportive ICD-10-CM codes.
  • Following the audit, an executive summary and completed audit template is forwarded to the client for each provider reviewed which demonstrates coding error rates and applicable findings related to the review.
  • Provider and staff educations is arranged following the review to assist with corrective action

WHAT WE NEED FROM YOU

  • HIPPA-compliant Business Associate Agreement (BAA) must be executed before the dissemination of any Protected Health Information (PHI) to adhere to HIPAA and HITECH requirements
  • A pre-populated Microsoft Excel spreadsheet will be forwarded to you to enter the patient demographic information and the specific CPT/HCPCS II/ICD-10-CM codes that were selected by the provider (or staff)
  •  Arch Pro Coding (ARCHPC) uses a HIPAA compliant Citrix service called Sharefile that is used for the transfer of electronic health records and PHI. Account access is assigned once scope of service agreements are executed.

WHERE TO GO FROM HERE

For a quote or more information fill out the contact form below.

 









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10/17/2019 » 10/18/2019
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ARHPC is a division of Universal Medical & Compliance, LLC
P.O. Box 1405 Tucker, GA 30085

Education :: Certification :: Audit Support

 

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