Interpretation and Reports Review
This is an often overlooked yet critical part of a review. A full 80% of both Optometrists and Ophthalmologists are either not creating an Interpretation and Report or not doing a proper report. We will review those procedures requiring an Interpretation and Report and validate that a proper report was created and available.
Clearly if you are not doing Interpretation and Reports, you would be hit very hard. The problem is those doctors who document Findings and consider that an Interpretation and Report. There are very specific requirements for Interpretation and Reports which are far more comprehensive than simply documenting findings.
An audit which uncovers reports with only findings will always result in return of full reimbursement for the procedure Plus Penalties Plus Interest.
What makes this especially critical is that Medicare is auditing specifically for Interpretation and Reports. We have seen throughout the country solo practitioners being assessed $40,000 to $50,000 or more simply for not having proper Interpretation and Reports.
Whether in a solo practice or a practice of multiple doctors, this assessment for missing or incomplete Interpretation and Reports will be very costly.