Medical Records Audit      
Reimbursement Review     
Compliance Verification     
Doctor Correct Coding Education     
Staff Coding and Reimbursement Training    

 

Appealing a Negative Audit           

 

   
Why an NPC Preventative Audit is Important to You           

           o Medicare, Blue Cross, VSP and other payers are performing more audits than ever before
          
o Payers have significantly increased the number of auditors.  Auditors are much more aggressive
          
o Some payers pay their auditors a bounty on how much they take from you.
          
o According to the payers, Over 90% of practices fail an insurance audit!
          
o Penalties for negative findings are between $150,000 to $200,000!
          
o Many doctors believe using an EHR system keeps them compliant.  Frequently this is not true. 
               Many EHR systems produce non-compliant records

             We know what the auditors are looking for.  We can protect your practice!

Practices hit with a negative audit are surprised and frustrated.  They previously passed and have the same record content. 

Regardless if it was only a "Request for Records" or an audit, all payers are more aggressive than a couple of years ago. 
The auditors are looking to find problems! 

Many Medical Records systems falsely verify exams as complete.  Missing key exam requirements.  Auditors look for these! 
Many doctors realize their EHR system has problems but have no alternative.  We can get your EHR system compliant.

We know what the auditors are looking for.  We will detail your exam deficiencies before the auditors do.

What an NPC Audit Will Do for You and Your Practice:

We will identify specifically where your records were not compliant, make detailed recommendations enabling you to be fully compliant! 

We will ensure you are creating compliant Interpretation and Reports.

Another advantage of our audits is that we look at lost reimbursement.  This includes:
           Based on your frequent diagnoses, we identify Procedures you should be performing for increased reimbursement.
           Lost reimbursement from incorrect coding, claims submission. 
          
We review your EOB processing.  Many practices do not process EOBs correctly, writing off amounts that should be billed to a
              secondary payer, the patient or were not properly billed in the first place.
              In EOBs identify why claims are denied or reduced.  Many billers do not use this information, losing reimbursement!   
           In most cases the lost reimbursement we find is more than the cost of the audit.

We can do the same for you!   Let us help you before you are audited!