HEALTHCARE CONSULTING SERVICES

Chart Reviews

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How Can a Chart Review Benefit Your Practice?

Reimbursement for Services Rendered Sounds Easy, Doesn’t It?

Chart reviews are a necessity to assuring that your practice is compliant and maximizing revenue for the services rendered.

Overview

Our Certified Professional Medical Auditor (CPMA®) healthcare consulting team are extensively trained, HIPAA compliant, and committed to accuracy and excellence. Our comprehensive chart review will improve the quality of your clinical documentation in electronic medical records, which will lead to accurate claims, ensuring you receive the reimbursement you deserve. We recommend performing regular chart review to establish compliance with regulatory guidelines and ensure you are managing an efficient and clean operation.

THE EDAFIO CHART REVIEW PROCESS

WHY SHOULD WE DO THIS?

  • Help identify lost revenue.
  • Identify the cloning of notes and code overuse.
  • Determine if documentation supports the service that was billed
  • Identify areas of opportunity for improvement and training within the organization.
  • Identify any outliers before large payers find them and request an internal audit to challenge inappropriate coding.
  • Help protect organizations against unintentional fraudulent claims and billing activity.
  • Failure to validate your provider’s coding & documentation puts your organization at risk

Common Findings During a Chart Review Include:

  • Cloning of notes
  • Upcoding or downcoding
  • Incorrect use of modifiers
  • Missed revenue opportunities
  • Over reporting of specific E/M codes
  • Overdocumentation due to improper use of EMR templates
  • Documentation that does not support the patient’s chief complaint
  • Reporting of E/M codes that equal up to more time than the provider is physically in the office

Provider Package Includes:

($1500 per provider to cover level of effort start to finish)

  • Ten patients per provider
  • Set up with access to EMR
  • Review three notes per patient
  • Research time
  • Write up report/review findings with staff
  • Provide comprehensive documentation on each chart note reviewed that consists of findings and recommendations
  • Discuss the findings of the chart reviews in detail

CONTACT US

Edafio Healthcare consulting team has decades of combined compliance experience in the healthcare industry. Our team has worked with numerous healthcare entities, business associates of covered entities, and other healthcare-related companies supporting their ongoing healthcare optimization needs.

There is no greater support than consultation and guidance. When you talk, we listen, then provide a tailored solution for your business needs. Our certified specialists are standing by to help.

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