When is the Best Time to Audit?
Before an Insurance Company Comes Looking!
I bet you guessed the answer. It’s now before an insurance company comes looking! There has been an abundance of records requests since the beginning of this year. I would imagine the providers that are receiving these requests wish they had initiated a chart review themselves before someone else asked to see how their documentation stood up to expectations.
When these providers look over what has been requested, they often see that the documentation is insufficient to support billing the service, or that there is a glaring lack of proper case management. Instead of clearly defined episodes of care, there are ongoing treatment plans that have been billed as active, medically necessary but based on frequency and/or duration alone, they are not.
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