tci Medicare Compliance & Reimbursement - 2007 Issue 38

AUDITS: Uncover The Top Trouble Spots Lurking In Your Charts

Here's how to find hidden revenue in common code claimsHeads up: It's not enough to do regular chart audits. You should be focusing on the most common trouble spots--and you could receive a big payoff for doing so.For example: "The billing staff at one [primary-care practice] failed to report any modifiers for office encounters, costing the practice $30,000 in unpaid services that year," says Curtis Udell, director of compliance and reimbursement with Health Care Advisors Inc. in Annandale, VA.Another audit uncovered improper modifier assignment, and the practice had no process to correct claims or appeal...

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