Corporate Compliance

Five tips to audit coders for compliant claims

Health Care Auditing Strategies, September 1, 2008

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Physician documentation plays a big part of the billing process in medical facilities. But no matter how clear and concise the documentation, a payer might still deny a claim due to mistakes made by coders and data entry staff members.

Don’t rely solely on the interview process or the reference check that a coder performs high-quality work or that he or she knows how to code for a particular specialty. “Without any monitors over the quality of the work, you really don’t know,” says Joe Rivet, CPC, CCS-P, CICA, a regulatory specialist at HCPro, Inc., in Marblehead, MA.

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