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Conduct a worthwhile internal coding/billing audit

Healthcare Auditing Weekly, February 13, 2007

You can't afford to lose revenue, especially when you have done the work to earn it. So how can you ensure that your office both protects itself from legal trouble and collects what it should? Consider performing annual mini-audits of your reporting, coding, and billing activities.

The audits serve the following four valuable purposes:

1. Identify discrepancies. By examining the information related to a specific service and comparing the documentation on various office records, your staff will see where and why services end up understated, overstated, or even lost.

2. Increase reimbursement IQ. As your reception and nursing staff examaine explanations of benefits (EOB) and see 30%-40% adjustments, they should begin to understand why they must properly capture every charge. Tracking the steps that lead up to the EOBs shows how to improve the results, which is a direct educational approach.

3. Improve awareness of coding's revenue-enhancing importance. By examining charts and billing information, your staff can better grasp the importance of accounting for every service rendered.

4. Teach teamwork. Again, stress to staff the importance of their individual actions as they fit together with those of their coworkers. A mini-audit involves all staff who have a role in coding and billing, as they team up to examine the process.

Next week we'll cover the steps involved in conducting a billing/coding mini-audit within your team.

Source: Improve billing and collections: Get the money you deserve now.

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