WCH Experts Provide Internal Chart Auditing Services

Regulatory pressure from President Barack Obama’s health care law — the Affordable Care Act — and other legislation has led to a significant increase in the number of audits being performed. In response to the federal call for accountability and cost reduction, the Centers for Medicare and Medicaid Services (CMS) is auditing doctors in much higher volume than ever before. In addition, insurance companies are auditing charts to ensure coding practices meet current standards. The auditors’ goal is to recapture costs by revealing poorly documented or improperly coded charts, and the consequences of poor coding practices include the loss of significant reimbursement sums as well as the loss of billing privileges with major insurance companies. For over 15 years, we have seen many challenging audit cases.

Leaders of medical practices can feel more confident if their charts are reviewed on a routine basis by billing and coding professionals. WCH experts not only offer this level of expertise but also continually build on their knowledge foundation through ongoing training and certification programs, including American Academy of Professional Coders Certified Professional Coder (CPC), Certified Family Practice Coder (CFPC), and Certified Professional Category Analyst (CPCA). They apply this know-how to all of their services as full-service billers, including internal audit and chart reviews to identify missing information and catch errors before they become costly mistakes.

With the constantly changing regulations, requirements, guidelines, and codes, it can be difficult for even the most diligent doctors and medical practice employees to properly chart and accurately code all their claims. However, the provider is held accountable for chart errors and shortcomings. WCH experts advise clients to send charts for routine monthly review and also during the audit process before submitting them to insurance companies for processing. In addition, WCH professionals strongly recommend doctors let their billers know if an audit is occurring right away.

Relying on WCH coders for internal chart audits has many benefits:

• We can analyze charts to catch incomplete and inaccurate information.
• Our certified experts can apply compliance best practices to ensure charts align with federal regulations and insurance policies.
• Our staff members can educate health care providers and staff about document requirements.
• We can help doctors avoid denied claims, overbilling and insurance errors, bundling issues, and matters with medical necessity.
• You can be represented by a company whose employees have years of experience winning audit cases.

Don’t let improper coding or a shortage of documentation lead to costly audit results, a loss of reimbursements, or penalties such as loss of billing privileges. We have more than 15 years’ experience helping medical providers with the chart review process.

With continuously updated audit certifications, WCH experts stay on the cutting-edge of coding and charting regulations so providers can focus on their work. With the help of WCH chart auditing, providers not only avoid costly mistakes but also gain peace of mind.

[cta]For more information about how WCH Service Bureau experts can help your office, contact us online or give us a call at (718) 934-6714.[/cta]