tci Medicare Compliance & Reimbursement - 2012 Issue 21

Self-Audit Your Way to Successful Claims

Self-audits aren't only necessary if your practice has been scheduled for an OIG audit. What it means: When you perform a self-audit, you're comparing your physician's billing records, claims, and medical records to verify expected treatment outcomes and medical necessity of services. In addition, you'll look for appropriate documentation to support fees and reasonable charges for services your physicians rendered.Why you audit: When you audit your physician's services, you can uncover incorrect coding patterns or compliance issues. The plus here is that you'll discover any problems before an outside auditor (such as one from the OIG or a...

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