Compliance Auditing
of Office Records
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The quality & completeness of your records will determine if this check is being written to you or by you back to the insurance companies because your records were incomplete.
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To get paid & be able to keep your money...
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Your records need to be Complete Compliant & Consistent
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Does your exam completely back up your plan of care and tests ordered?
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Is your diagnosis congruent with the treatment ordered and rendered?
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Does your billing reflect the actual services rendered?
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Will you survive an audit?
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Are you aware that health care lawyers now charge upwards of $500 per hour to audit and defend you?
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Did you know that insurance companies are very patient and will review & analyze your bills and notes submitted up to five years before acting?
CMCS Management's Audit Department will review your records for:
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Completeness of SOAP
notes
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Thoroughness of evaluations & re-evaluations
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Timeliness of evaluations & re-evaluations
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ICD and CPT cross linkage
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Claims matching services rendered
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Services performed were ordered and services ordered were performed
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Letters of necessity are clinically accurate
All chart audits are done in strict confidence complying with all Federal HIPPA regulations and your State Law
From the publication Family Practice Management, Ronald W. Bradshaw, MD, CPA writes "Given
the federal government's increasing interest in ferreting out health care fraud and abuse, practices that don't implement compliance
programs could be putting themselves at risk…. external audits, which may be prohibitive for smaller groups (a small practice
can expect to pay from $2,500 to more than $10,000 for an external audit, depending on its extent and the number of physicians involved)."
Cost:
Option #1
$500 for 5 charts audited with a report*
This will give you a basic understanding of your paperwork. 5 Charts are enough to uncover some problem areas and what needs to be done to correct the deficiencies.
Option #2
$1200 for 12 charts audited with a report*
This will give you 3 charts per financial class; Personal Injury, Worker's Compensation, Managed Care, Medicare and Cash (choose 4 of the 5.) Each additional chart per financial class will give you a greater statistical certainly that for each class your documentation is complete, compliant and consistent.
Option #3
$250 in addition to the above costs*
This is done and billed through a lawyer's office as many doctors have on-going legal issues and need the client-lawyer privilege.
* Denotes auditing 3 months of services or 30 visits
To get started or to chat, contact:
Michael Schonfeld DC, DABCO
(516) 695-7732
Chirodoc006@gmail.com
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