Coding Compliance Audit report

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Heres what 2016 taught healthcare CFOs about
revenue management
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A thorough revenue cycle audit should consist of
Medical coding audit Contract performance
auditAR auditDenial prevention auditCompliance
audit
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1 Coding Report A dashboard for better coding
practices
Your coding report should Lists out CPTs,
DRG/HCC/APC and the code auditors accuracy
ratings Surface the dollar differences spotted
between payer contracts and reimbursed
codes Give clear recommendations for remediation
based on audit goals
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2 A complete audit of contracts Seal the cracks
3 point checklist
The contract audit report should consist of a
detailed payer matrix It should list out various
contract elements Offer data that will help in
payer contract negotiation leverage
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3 AR audit- Know the story behind the numbers
Know what your AR audit report should
consist of The AR management audit report
should examine historical AR valuation
activities The AR auditing team should clearly
evaluate current AR reserve estimates A concise
AR audit report helps revenue cycle managers
to identify positive and negative AR trends
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4 Denial audit- Because data matters
Heres what to look for in your denial audit
report The denial audit should help you to
increase denial management efficiency It should
categorize denials by denial code/payer/dollar
value and other vital denominators Determine the
reasons behind untimely follow-ups
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5 Compliance audit Mitigate compliance risks
Know what your Compliance Auditor should do
The compliance auditors should perform risk
assessment checks and determine the level of
risk Check compliance with internal
policies/payer guidelines and federal
regulations Audit and report the highest risk
areas
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