In healthcare, coding and documentation errors are two of the largest contributors to lost revenue that can be rectified. A properly designed audit program can help identify common coding and clinical documentation errors, compliance concerns, and overall accuracy.
CorroHealth’s auditors offer in-depth reviews of coding and clinical documentation findings based on best practices in the industry along with client policy and procedures. Our coding and CDI audits can help you improve your staff’s efficiency and accuracy, reducing errors that lead to claim denials and other revenue losses.
We follow a structured process that has proved successful for each of our audits.
The process begins with an overview of systems, including access to records and an introduction to the EMR and CDI platform. Incorporating facility policies and Coding Guidelines, CorroHealth’s auditors perform a detailed coding and clinical documentation audit, including CDI query review, notating their findings throughout the process.
Once complete, our team provides each client with an audit workbook and scorecard that outlines their recommendations and audit accuracy and cites references (Coding Clinic, Coding Guidelines, CPT Assistant, etc.) to support a corrective approach.
We will present our client with the preliminary results of the audit, offering a chance for the team members whose work is under review to provide a rebuttal. Clients are encouraged to share their thoughts on the findings and thoroughly review the results using a collaborative forum. The team reviews the rebuttal responses, and if changes to the audit findings are needed, they are made at this time.
Clients are given the final executive report and an audit workbook that can be used to educate current and new team members for better accuracy and best practice. This report includes a scorecard summarizing key findings for the management team and presents an overview assessment of the results. Individual scorecards are also created for each team member reviewed in the audit to help with professional growth and show areas of strength.
Our coding audits span the healthcare gamete, covering facility and ProFee reviews. Our auditing team has the skill set to evaluate all coding components, including but not limited to diagnosis, PCS, CPT, modifiers, discharge status, DRG, present on admission (POA), query opportunity, observation hours, and much more.
The CDI audit reviews for query compliance and composition and missed query opportunities, reporting financial misses and the severity of illness, risk of mortality, HCCs, and quality components. An overview of the coding is also performed for appropriate diagnosis capture and DRG assignment.
Once the audit is complete, we will present findings and deliver educational materials to help improve understanding of areas of improvement and patterns seen during the review. These educational work sessions are held remotely on our client’s schedule.
We tailor our audits to your specific needs. Your reasons for conducting an independent audit will not be the same as other hospitals or healthcare practitioners. Before starting our audits, we get to know you: your needs, goals, and objectives, covering the data you care about.
Our team of auditors, many of which possess multiple credentials, has an average of 18 years of industry experience and is dedicated to auditing, education, and mentorship services. Our team will focus on you and your audit without being distracted by other responsibilities.
The team will meet with you weekly during the auditing process, including an Auditing Senior Manager and Auditing Supervisor. Our education team uses your individual audit results to tailor meaningful education that promotes understanding along the educational journey. Each team member is committed to quality, accuracy, ethical integrity, and you by helping to keep your audit on track.
