Corporate Compliance

Identify and assess evaluation and management

Healthcare Auditing Weekly, August 31, 2004

To identify problem areas in evaluation and management (E/M) services, perform a baseline audit and review the billing report for the following patterns and practices:

  • Physcians who always assign the same level of E/M service

  • Unexpected codes (code categories, E/M levels, procedures, or modifiers)

  • Codes not being used that one would expect to see

  • Patterns that differ from national norms or from others in the group practice

    To learn more about this important process, order the book "Hospital Auditing and Monitoring: Sample Programs for Key Risk Areas," published by HCPro, Inc. This binder and CD-ROM are filled with actual audit programs used by auditors and compliance officers in the field. Click here for more information or to order your copy today.

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