Audits & Assessments

Assessing for Opportunities

Detect and correct errors to ensure accurate reimbursement. Our team of regulatory specialists can assist you with a variety of audits and assessments:

• Inpatient services: A wide range of topics, including MS-DRG review, proper code assignment and more
• Outpatient services: Review of charge capture and coding accuracy keeping revenue integrity in mind.
• E/M audit and review: Ensure appropriate leveling and documentation for professional and facility services
• Audits of RAC-identified errors: Detect and correct coding errors on challenging areas prone to RAC scrutiny.
• Practice operations assessments: A comprehensive audit and review including operations manual and training.

Contact us at (877) 233-8734 or info@hcpro.com or use this form.

Click here to read our case studies.

Click here to download the Revenue Cycle Institute brochure.

Our Methodology

We can help you with areas that you know need a third party’s objective expertise. Whether it’s a pointed audit looking at specific areas of concern or an ongoing audit scheduled at regular intervals to maintain compliance, our team of experts is on the job.

We have processes in place to audit your records remotely or on site. We’ll schedule a kickoff call with you and your team to get all the details ironed out. Then, our field work phase begins. We do a thorough chart review that includes a spreadsheet of actual code assignment next to our suggestions. And we back it up with citations and primary source authority so you know the extent of the regulations. It’s what we adhere to each and every time.

We end every engagement with a written report and a conference call to discuss what we found and how your team can improve moving forward. We can structure the report based on your needs including an analysis per individual and a roll-up report. That way you can take the findings and use them to educate your team.

Our Model

The true HCPro advantage is that our auditors are not only regulatory specialists, but expert educators. We can easily take the audit results and create a custom education session to train your staff. That way, you have an insurance policy against staff maintaining the status quo. Our educators will weave sample charts into case examples as part of the course materials to create relevant lessons. It’s an effective way to unlearn suboptimal behaviors.

We work on site or remotely, depending on your preference. We’ll interview key stakeholders, provide follow-up Q&A services and conduct follow-up audits to ensure best practices are being followed.

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