If you want to improve the quality of your practice, you can ask a company like New England Accounts Receivable Management to do the chart auditing for you. We will analyze your facility’s medical documents and look for discrepancies, improper code selection, and under-documentation.
We can help you find the points you can improve on. With our chart auditing service, your clinic in Worcester, MA can have increased revenue and faster reimbursements upon implementing the procedures we have recommended.
What Happens During a Medical Chart Auditing in Worcester, MA?
A medical audit is a program that aims to improve the medical operations of a healthcare institution. By electing for an audit, experts can pinpoint certain aspects in a clinic’s operations that need to be improved.
It involves the internal and external reviews of coding accuracy, policies, and medical procedures. If you are wondering what auditors do during a medical audit, here are a few things that they can help your practice with:
Preparing and Creating Criteria for the Medical Audit
Before any audit project, an auditing expert, together with the physician, will create a plan to determine the problems that the facility needs to address.
Auditors usually consider some factors that will help him or her recognize what topic the organization should immediately resolve. The ideal topic that auditors tackle are problems that have a significant impact in terms of risks and resources, or cost and issues that can easily be evaluated.
Once internal issues have been recognized, an auditor will proceed in generating an audit criteria as a measurement to fix any complications. The criteria consists of indicators and standards. The indicators are variables that help auditors identify the root causes of medical issues and the standards are the action plans.
Gathering Necessary Data and Applying Changes
After the auditor is done identifying the health institution’s problems and creating his/her audit criteria, he or she will now proceed in collecting data. An auditor can gather data using the retrospective chart review method. Retrospective review is where the auditor assesses the facility’s documents and garners important information.
Data gathering is very systematic when it comes to auditing, so auditors always record every information. Once necessary data are collected, the auditor will summarize and analyze it to formulate a concrete action plan to resolve the institution’s internal problems.
What Are the Benefits of Having a Chart Audit?
As a health provider, choosing to have an external auditor can help improve your quality. If you are wondering why a chart audit would benefit your company, we will show you the advantages of chart auditing. Here are some reasons to hire an external auditor:
Point Errors in Documentation and Practice
An external auditor is hired to improve the quality of care given to patients by reducing the chances of committing malpractice through effective record analysis. Using your clinic’s medical logs as reference, he/she will see what kind of treatments were given to each patient.
If there are issues with your documentation, there will be a lack of transparency reflected in the charts. Aside from that, improper documentation may be the cause of delayed reimbursements.
Give You Objective Feedback
You should secure the services of an auditor who has already handled plenty of healthcare institutions or providers. You will know if your clinic is abiding to medical standards or not based on his or her investigations.
From external audits, you will be able to discover some missed clinical processes and identify why other treatments were unsuccessful. By employing a professional auditor, you can have a bird’s-eye view of your operations.
Provide Recommendations for Your Practice’s Improvement
When the auditors are finished reviewing medical records, they will give you action plans that you can implement. Auditors can help you fix and avoid issues in the future through detailed data collection, reports, and points for improvement.
Help Perfect Your Coding and Documentation
Updating your evaluation and coding is also vital in hastening payments from insurance. Aside from that, you can improve your chart inputs and be consistent in adhering to medical standards and guidelines with the help of an audit.
Insurance and federal investigators may inspect and look for evidence of malpractice. When you have clean and well-documented medical procedures, you can avoid having issues with them and continue with taking care of your patients instead.
Faster Claim and Compensation for Your Healthcare Service
When you have an improper code selection, it might hinder you from receiving compensation easily. However, you can have better documentation once the audit is finished.
You, as healthcare providers, will have fewer problems with payer policies, coding rules, and other issues. This means that insurance companies will give you reimbursements faster.
Measure and Improve Quality of Care
By electing for an audit, you will know the level of care you are providing to your patients. An auditor, not only evaluates proper documentation and coding but also, assesses the medical treatments administered to patients. The auditor can determine poor medical practices by using the information listed in the records.
Your staff can learn from these audits to enhance the quality of medical care. You’ll know if you still need to improve your performance or if your treatments are following standards. With the help of an auditor from a factoring company, you and your medical staff can provide better treatments for your patients.
Why Should a Healthcare Facility Opt for a Clinical Chart Auditing From a Factoring Company?
It is possible for you to run your own audit, but it’ll be an arduous task. It is difficult to analyze and evaluate internal logs while giving effective healthcare to your patients. The last thing you want is to jeopardize the welfare of your patients because of incompetence and poor medical practice.
If you are currently mishandling records, hiring a factoring company would be helpful. The company’s auditors will assist you in managing internal discrepancies before large payers discover them. They will also protect your clinic from having counterfeit and billing activities.
If you are having trouble with reimbursements, an auditor can correct your reimbursement deficiencies. In addition, he or she can prevent the use of incorrect codes. Lastly, you can avoid the hassle of getting inspected by the government with help from a factoring company’s chart auditor.
What Should You Look for in a Medical Auditor in Worcester, MA?
The importance of choosing the right auditor is necessary, and it should not be overlooked. With so many companies offering the same services, you must select an auditing firm that has qualified auditors.
You want a medical auditor who graduated with an associate degree in health information. He or she should also have a background in critical coding concepts. Your prospective auditor must have experience in medical documentation, abuse, and fraud.
He or she must be detail-oriented and accurate. It will also be beneficial if you employ a chart auditor who already has a professional medical auditor certificate. Lastly, your prospective candidate should have strong communication skills for sharing findings and results.
Choose New England Accounts Receivable Management to Help You With Your Chart Audits
Updating your organization’s clinical records is very important. However, with all the activities happening in your clinic, it is challenging to determine which part of your medical process needs improvement. One way to address this problem is to apply for a formal chart audit.
At New England Accounts Receivable Management, we are committed to providing quality clinical audits to identify if your health center is doing well or underperforming in certain medical operations. We have more than 30 years of medical billing experience.
New England Accounts Receivable Management offers several services. Our company can handle third-party insurance claims, billing inquiries, and self-pay statements. When you work with us, you can ensure that your institution will have an increase in revenue and improve patient satisfaction. Contact us to learn more!