Chart Audit Services
One of the most often overlooked aspects of practice compliance can be found in your medical charts and billing practices. The standards for medical charting are always changing and if you aren’t staying up to date, you could be leaving money on the table or making yourself vulnerable to fines and legal trouble — or both.
With the PCS Comprehensive Chart Audit, we double and triple-check your billing and coding policies and standards to make sure that you’re getting the maximum value out of each patient encounter and not opening yourself up to potentially severe regulatory issues.
The Consequences of Non-Compliance
The laws surrounding billing, coding, and medical documentation are not only binding and enforced by law, they change regularly and often without warning. As such, there are steep consequences to not adhering these regulations — consequences for which ignorance of the laws is no excuse.
The penalties for inaccurate or falsified medical documentation include heavy fines and removal from the provider panel. This is true to medical and vision plans. Every year, federal and state governments levy millions of dollars in fines that could have been avoided by trusting the experts to look over your charts.
Incomplete charting or billing could be costing your business too: across all medical care in the United States, approximately 3-5% of annual revenue is lost by inadequate documentation, equaling about $125 billion per year.
Hear From Other Professionals:
“Everybody thinks they’re doing a good job. They don’t think they need somebody looking over it, but it’s a sobering effect when somebody does look over your practice and tells you what you’re doing wrong or that you missed out on $70,000 last year because of incorrect billing.”
– Dr. John McCall
Choose the Right Audit for Your Practice
PCS offers two different audit services to serve the unique needs of your practice: Comprehensive Chart Audit Service and Fraud & Abuse (F&A) Chart Audit Service.
Our Comprehensive Chart Audit goes beyond medical records to meticulously analyze billing and coding practices as well. 20 charts per provider is recommended but customizable packages are available for larger offices or practices with multiple locations. Once the audit is completed you’ll receive a thorough report of any documentation, billing, and coding issues we’ve found as well as insight on the financial impact of any lost revenue due to charting or coding errors. The cost is $1500 per 20 patient encounters, and you are not charged until the audit is completed.
Our Basic Audit meets the minimum audit recommendations from CMS. Much like a real medical record audit, billed services are compared against the medical record documentation but only to determine if the services should be paid or not. This audit is priced at $750 per 10 patient encounters.
The Comprehensive Chart Audit is the best way to ensure both maximum compliance and maximum reimbursement. While CMS allows providers to “self-audit” their records, PCS highly recommends a professional audit initially and then at least once every 3-5 years. With both audits, you can operate with the peace of mind to be more confident in your billing practices and focus on providing excellent care to your patients.
If PCS identifies problems related to your initial billing service, our Revenue Cycle Management service is available to help you solve those issues and make sure your billing is conducted accurately and efficiently by industry experts.
Training audits are the best way to ensure your practice will be ready and safe when a real auditor comes around.
| Comprehensive Audit | Basic Audit | |
| Number of charts reviewed | 20 per provider | 10 per provider |
| Ensure maximum billing reimbursement | √ | X |
| Ensure CMS billing compliance | √ | √ |
| Identify possible lost revenue | √ | X |
| Recomended Frequency | 3-5 Years | Yearly |
| Cost | $1500 | $750 |
never worry about compliance again
Join the thousands of practices who are staying protected with PCS