The off-site audit service is carried out by physical therapists with extensive knowledge about payer payment and coverage policy. These services are unique because any aberrant finding is addressed and evaluated from a compliance as well as a risk prospective. Additionally, each audit is performed at the therapist level. Executive Reports provide strengths and weaknesses as well as recommended action plans for high risk and vulnerable areas, if applicable.
All audits include valuable resources and references to assist the practitioner to take advantage of opportunities to improve documentation and/or billing. BCMS often provides ‘train the trainer’ consultation to the facilities audited so that they can carry out internal audits.
It includes auditing of:
- Patient clinical and billing chart revews (typically 2 -3 Medicare patients; private payers upon request)
- Chart completion (documentation elements and requirements)
- Billing compliance (proper unit, CPT code and modifier selection)
- Corrective action as needed (based on regulatory requirements)
- Resources and references
- Executive call regarding audit findings
- Clinical and billing audit for each therapist
- Written Executive Report (optional)