March 2017

March 2017

An Audit… Not If, But When

There once was a time when a doctor could throw insurance claim forms up in the air and it rained down checks—figuratively speaking of course.  In today’s age of the post-payment audit and the pre-payment review, it’s imperative that each practice takes documentation and coding seriously. It’s no longer a matter of simply clicking a few boxes in your EHR software and expecting to be paid.

Insurers are coming back to doctors, sometimes years after having been paid, and comparing the documentation with the billing to see if it meets the standards of medical necessity. They’re literally asking, “Did you deserve to be paid for that service?” If the answer is “no,” be prepared to write a refund check!

This may sound horrifying, and it can be, but you can take a proactive approach. Schedule and perform periodic self-audits. Reviewing your own charts and billing a few times a year on a select sampling and documenting your findings and intended corrections will bode well for your practice. Or better yet, hire a professional to look with professional eyes in a safe environment to outline areas that need attention.

Viewing your documentation and billing through the eyes of a third party will give you greater confidence and improve the quality of your exams, notes and case management. And reimbursement.

“I Hate My EHR Software!”

It’s a common tale.

You’ve spent precious resources on documentation software, the expensive equipment to run it and the steep learning curve to understand it. And hate it.

It’s a sign to return to an integrated, low-tech paper documentation system. At least for a season.

The Paperwork Project is a comprehensive system that collects the essential information on the intake form that you’ll need to prove medical necessity. The examination forms to record your findings. A SOAP note that fulfills your daily visit obligations. A re-evaluation form to document their improvement. A dismissal form to transition patients to cash-paying maintenance care and minimum daily note for their ongoing care.

Simple. No function keys. No macros to master. No awkward silences with patients as you search for the right code.

Review each form, personalized for your practice. Supplied as a print-as-many-as-you-wish PDF. Use the discount code PEARL100 at checkout to save a hundred clams. (Hammer not included.)