Auditing Services

Medical chart audits are a necessary function in the healthcare administrative process. A medical coding audit provides detailed information about the overall operations of the medical practice including coding, billing, documentation, reimbursement and compliance. Our auditing team is multi-distinguished holding active credentials as Certified Professional Medical Auditor (CPMA), Certified Medical Auditing Professional (CMAP), Certified Professional Compliance Officer (CPCO), Certified Healthcare Compliance Officer (CHCP), and Certified Professional Coder (CPC). Our Senior Auditor leads the team with over 20 years of experience.

Most Requested Audits

Evaluation & Management
Behavioral Health Services
Revenue Cycle
Anesthesia
Emergency Care
Surgical Procedures
Physical Therapy
Documentation

Audit Sample Size

Most requested- 10 Charts/p

2) 20 Charts / Provider

3) 25 Charts / Provider

4) 15 Charts / Provider

5) 5 Charts / Provider

You determine how many charts we audit!

Where we Audit

Onsite at your location
Remotely
Hybrid Audit- a combination of onsite and remote

What we Audit

Coding
Documentation
Reimbursement
Compliance

Revenue Cycle Audits

MCHC Revenue Cycle Audits are entirely customizable and scalable to meet the needs of each client. Revenue disruption and obstacles affect everyone, regardless of the size of the practice. Our certified revenue team is ready to evaluate, locate, and assist you to recover and retain your revenue.

Front Office Operations (Patient Registration, Insurance Verification, Collections, Scheduling)

Administrative operations (Provider Credentialing, Payer Contracts, IT and Systems management)

Coding (Documentation, Coding, Denials, Payer Correspondence, Fee Schedule)

Billing (Timeliness, Carveouts, Payer Policy, Denials, Access, Process)

Compliance (Identify risk level, False Claims, Stark, Anti-kickback, Exclusion)

Back Office Operations (Patient Statements, Payment Posting, Patient Balance Collection, Debt Collection)

Getting Started:

1) Determine the type of audit needed. Our team can assist by recommending an audit once we understand your objections and you as a client.

2) Determine the number of charts to be audited.

3) Determine a deadline for the audit

4) Complete audit agreements, HIPAA agreements, and establish primary contact

5) Establish chart access

6) Receive the audit report with findings and recommendations

7) Set up an optional conference call to discuss findings, recommendations, and next steps

8) Organize optional training, if recommended

Medical Chart Audits

MCHC Medical Record Audits are entirely customizable and scalable to meet the needs of each client. Our detailed chart audits will provide a snapshot of coding and documentation within the practice providing confidence and validating your accuracy level. Our certified chart auditing team is prepared to meticulously evaluate medical record documentation and coding practices to identify areas of potential risk and establish a plan of correction if needed, and encourage a plan for a solid foundation moving forward.

What will a Medical Chart Audit Provide?

Uncover overpayments and ensure timely repayment to prevent false claims liability of penalties / fees
Recognize areas of potential risk, ensure prior identified risk areas were effectively resolved
Minimize denials, provide assistance with identifying denial trends quickly to minimize affects
Review documentation for billing, coding, and legal risk
Ability to look at operations to ensure accuracy, efficiency, and effectiveness of policies
Strengthen coding and billing operations against governmental and/or payer audits
Bring missed revenue to light by identifying missed codes, under-coding, and other deficiencies
Peace of mind permitting for greater focus on patient care

Findings and Recommendations

Regardless if MCHC completed your audit or another organization it is highly likely the findings and recommendations will involve policy and procedure changes and/or include the need for additional training and development. MCHC can assist your organization with reviewing and improving internal policies and procedures and staff training.

Allow us to customize training for your team to ensure they receive the information needed without wasting money on training items that are not necessary for your practice. Save additionally on training cost as we host the training virtually. Onsite training is available!

Training we provide:

Compliance (HIPAA, OSHA, Annual Updates, Laws and regulations)
Coding (ICD-10-CM, CPT, HCPCS, modifier usage, sequencing)
Documentation (Improvement, Proper provider inquires)
Billing (Operations, Overpayments, Timeliness, Denials)
Provider (Documentation, Coding, and Medical Decision Making leveling)

Medical chart audits are an essential aspect of the healthcare industry. These audits involve a thorough review of patient medical records, modifier usage, quality of care, documentation, proper reimbursement and compliance. The goal of medical chart audits is to ensure that healthcare providers are providing high-quality care and following established protocols.

Performing chart audits has numerous benefits for both healthcare providers and patients. One of the most significant benefits is improved patient safety. By reviewing medical records, healthcare providers can identify potential errors or omissions in patient care, such as medication errors or missed follow-up. This allows for timely intervention and correction of such errors, improving patient safety and reducing the risk of adverse outcomes.

Medical chart audits also help to improve the quality of care provided by healthcare providers. By reviewing patient records, healthcare providers can identify areas where they may need additional training or education. They can also identify patterns or trends in patient care that may indicate a need for changes in treatment protocols or policies.

In addition, chart audits are an essential tool for healthcare providers to ensure compliance with regulatory and accreditation standards. Audits can identify areas where the practice may be falling short of these standards, allowing for timely correction and improvement. Audits provides the opportunity to identify missed revenue, identify areas of risk, challenge coding practices, improve documentation and to mitigate potential risk areas currently on the Office of Inspector General's (OIG) Work Plan.

Auditing Services

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