No one likes paying for an oil change or tire rotation every few months. And no one likes chart audits. But just like the return on investment for your vehicle, consistent attention and oversight of medical coding is critical to the bottom line for anesthesia practices. Below are the top five reasons why your anesthesia practice should invest in professional, external audits of your charts:
#1. You’re not being paid as much as you deserve.
Everyone in your anesthesia practice works hard and deserves to be compensated at the highest possible level. Oftentimes, chart audits reveal under-coding, representing lost revenue. Auditors look critically at the entire chart and ask questions such as: Did you provide the service? Did you document it correctly? Are you capturing all of the services provided? Are you reflecting the number of base and time units correctly? Are you submitting an unspecified diagnosis? If so, why? Does your diagnosis meet medical necessity?
#2. Friends are better than foes.
It’s better to have issues and inconsistencies found by a “friendly audit,” before the payers or Medicare review your notes. Over-coding and other poor coding practices—regardless of intent—are putting your anesthesiology practice at financial and legal risk. For example, a chart audit may uncover issues supervising CRNA’s. Concurrency issues are fraught with potholes of poor documentation leading to reductions in payment. Many Practice Management programs calculations for time may not be rounding your time units correctly. We frequently remind providers that EMRs and search engines are tools, they are not a replacement for good coding.
#3. Some of your providers need education and refresher courses.
The healthcare industry is moving at such a fast pace that physicians don’t have time to stay on top of coding complexities. In addition, many anesthesiologists work in multiple facilities with different EMRs. A professional chart audit identifies inconsistencies among providers, documentation deficiencies and specific areas where training is needed. Customized training programs using your EMR(s) can be developed to quickly bring providers up to date.
#4. Your practice needs help keeping up with changing Medicare and insurance regulations and requirements.
You’ve survived the ICD-10 transition, but are you thriving? Physicians must transition from the “fee for service” mindset of coding and move to the value-based mindset of coding. For example, it’s easy to code the minimal amount in order to get paid. It’s much more difficult to code the co-morbidities and complications that prove just how sick a patient is in order to be reimbursed appropriately.
#5. You need a fresh set of professionally trained eyes.
Of course you’re using Certified Coding Specialists, but are they experts in your specialty? Do they understand the nuances in your medical terminology? How does their productivity compare to industry benchmarks? A chart audit takes a fresh, unbiased look at your coders’ productivity, accuracy and knowledge, and makes recommendations for improvement.
In order to keep your anesthesia practice running smoothly and at peak financial performance, it’s a prudent business practice to have an external chart audit performed annually to identify missed revenue sources and potential compliance issues. The positive impact on your bottom line will justify a professional chart audit year after year.
Thomas Maher, CPA, CPC
President and CEO
Practicefirst Medical Management Solutions