MEDICAL RECORDS REVIEW PROCESS
HOW DO WE DO IT?
We use a state of the art web-based system that applies over 5 million payer edits to all diagnosis and CPT codes and checks
every code and code sequence. These include NCCI, NCD, LCD, OCE, Medical Necessity edits for all 50 states. Our software
rules engine enforces coding policies to provide in-line quality and compliance.
WHAT IS THE PROCESS
Our Audit Guard solution is a very simple process. Once you are ready to have us review your charts, we will ask you to gather some information to send all
together in one package. The following information is what we need to get started:
- The signed agreement and HIPAA compliance statement between your practice and Profast Billing Solutions
- The HCFA 1500 claim form you used to submit the claim being audited
- All documentation that supports the billing on the HCFA 1500 form (ex. Office notes, x-rays, labs, etc )
Once gathered the documents can be delivered to us either by mail, fax or through a HIPAA compliant email system that we can help you set up. The information
is then distributed to our team of coders with experience in your specialty. After each chart is reviewed for coding it is run through a proprietary Coding Analyzer and
Rules software engine. From there all work is reviewed for quality assurance, and then a report is returned to you usually within 48 hours. This report will help you
identify areas of risk for your practice and also provide training for documentation techniques that could improve your workflow. We will also recommend corrective
actions that can help reduce your risk of an audit and help increase cashflow.
View a SAMPLE REPORT HERE
With the purchase of at least a 25 chart review, in addition to receiving a detailed analysis of our findings you will also be scheduled for a 30 minute phone consultation.
This is a great opportunity to speak with a coder and ask questions regarding the coding analysis report that you receive.
HOW DO I GET STARTED? - CLICK HERE | 