Chart Audits

Adviri's certified coders will provide an in-depth analysis of coding and billing techniques to identify deficiencies and potential opportunities for future revenue enhancement. A complete report will be provided with specific analysis of each encounter reviewed. Adviri will review the claims for timeliness, completeness and enclosure of appropriate attachments when necessary. Adviri will evaluate the procedures for follow-up of unpaid claims and resubmission of denied and rejected claims. The desired result is reduced claim rejections and denials, more "clean claims", improved cash flow and appropriate reimbursement.

As part of our evaluation process, we will review the current encounter forms/charge ticket being used in each clinic and will analyze the procedures for collecting and verifying patient personal and insurance data and make specific recommendations as necessary.

At the conclusion of our review, we will hold an exit conference with the physicians and staff to address findings, present conclusions and make specific recommendations. We will review the principles of documentation and provide guidance to help the physicians develop a clearer picture of the information the insurance companies, particular managed care companies and Medicare/Medicaid require. We then show how the documentation determines the level of service selected for the encounter and provide pointers for increasing levels of service and revenues. We also show ways in which more comprehensive documentation allows the staff to select a more specific ICD-9-CM, CPT and HCPCS codes as required by Medicare and private insurance carriers. We also discuss any legal or risk management problems identified.