Healthcare Audits & Reviews for ENT Practice Medical Billing

One of the best ways to maintain compliance and ensure that your medical billing processes are on target is to perform a healthcare audit. There are lots of audits that should be used on a regular basis for your Otolaryngology practice or clinic. For example, surgical chart auditing and an annual fee schedule review should be part of any successful practice. Offside CPA audits and other tools can be used to spot billing issues before they become big and costly problems. While some practices choose to do these audits and reviews in-house, studies show that external audits are more successful, especially when a critical, non-partial review is required. Healthcare audits are designed to catch coding errors and potential fraud early on to avoid serious complications that could cause irreparable harm to a growing practice.

Choose a Trusted Provider
The first and most important step in healthcare audits and reviews is to hire a trusted provider who has the knowledge, experience, and insight necessary to provide you with the information you need to make a positive change. The external auditing company should offer a broad range of services that are designed to work with your specialty for best results. So whether you require just a basic review of your billing and coding practices, or desire a more comprehensive solution that includes offside CPA audits, an annual fee schedule review, and surgical chart auditing, you will be able to get everything you need without having to hire multiple providers to get it.

The primary reason why an external audit is more beneficial than an internal audit is that you will sometimes have a situation where the employee performing the audit goes “too easy” on a department and doesn’t provide the full information about what went wrong. If they don’t notify the office manager about the issue with billing, coding, or another aspect of the accounting department, they won’t be able to correct it in time to make a difference. That being said, a healthcare audit of any kind that doesn’t dig fully into the operation to discover even minor problems or issues, is a waste of everyone’s time. It is important to be serious about any type of audit or review.

Hold Staff Accountable
It also won’t do anyone any good if there isn’t a system of accountability in place to hold staff members who consistently make mistakes, such as coding errors or neglecting comprehensive record-keeping steps. Having a system in place before you perform a healthcare audit of any kind makes it clear that whoever is responsible, whether it is a regular employee or a supervisor, the guidelines have been set for steps that will be taken to correct the situation. Honest mistakes can be corrected through training, education, and ongoing support. However, errors that are done purposefully or due to outright disregard for regulations and industry requirements could result in termination. Any type of fraud that has been occurring that is spotted through offside CPA audits and reviews should be addressed immediately without prejudice.

Do Something About It
When you do discover issues or mistakes that are being made, it is important to make sure that something is done about it right away to correct the situation. Surgical chart auditing and an annual fee schedule review should be done regularly to prevent related issues from occurring. This is just a smart business practice. However, other healthcare audit tools, such as those for billing and coding or account management should be done whenever you notice claims being denied or rejected by the payer. Coding errors can be serious and, if left unchecked, could result in a delay of payments and cash flow issues for the practice.

Once the issues are identified, MD Pro Solutions can work with you to perform an assessment to determine what the best course of action should be to correct the problem. Educational programs, training sessions, online support, and other methods can be applied to ensure that it doesn’t continue happening in the future. If the problem is widespread, billing and coding can be outsourced while training occurs to correct problems with denied or rejected claims and get revenue flowing back into the practice. In some situations, a new medical billing system may be required to ensure efficiency and effectiveness when the billing and coding go back in-house to your accounting department.

Trust MD Pro Solutions for Audits & Reviews
If you are in the market for an external provider of healthcare audits and reviews for your Otolaryngology practice or clinic, look no further than MD Pro Solutions. With over 45 years of experience working in the medical accounting and management industry, our team of specialized consultants, educators, and support providers can help you get your office back on track. Give us a call at 508-946-1665 and speak with one of our knowledgeable team members to schedule a FREE evaluation of your current practices and system. Whether you require an annual fee schedule review, surgical chart auditing, offside CPA audits, or any other type of healthcare audit, MD Pro Solutions can help you to achieve your goals.