Get a detailed review of your practice.
Our customized chart reviews include an analysis of paid claims as well as claims prior to submission. The chart review may be performed on-site at your practice or completed remotely. Our team will work with you to determine what will meet your needs (further described below).
Retrospective audit
This type of audit involves a look-back at previously paid claims. The look-back period can be adjusted to accommodate your needs. It often includes a minimum of 10 charts per provider with a 6-month or 12-month look-back period. Under certain circumstances, we may review a single date of service.
pre-payment audit
Generally, this type of audit involves a single date of service. We ask the practice/ASC to hold a small sample of claims, for each provider, prior to submission. This allows the practice the opportunity to address any errors or inaccuracies prior to filing the claim which may mitigate potential risk for the practice/ASC.
Chart Review Considerations
Questions to consider when seeking a chart review
Does your practice/ASC have specific concerns or issues?
Does your practice/ASC want to look back at claims that have already been processed?
Have you received a notice from a third-party payor?
Are you concerned about under/over-payments?
Results
The audit results are memorialized in a customized report. Our reports can be provided as an informal summary of key findings or a detailed analysis. The detailed report includes a complete listing of all transactions, overall practice data, and individual provider results.
Our team will work with you to determine the best option for your practice/ASC.
"Chart reviews are an invaluable tool that can identify opportunities, mitigate exposure, ensure compliance, and direct on-going training for the practice."
Kirk Mack, Senior Consultant
BSM Consulting