1 / 8

Denial Claims Audit Report

To stay in compliance & profitable it is imperative that healthcare organizations conduct regular audits. This is the most important lesson learned by CFOS & practice managers in 2016.

charlese
Télécharger la présentation

Denial Claims Audit Report

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Here’s what 2016 taught healthcare CFOs about revenue management

  2. A thorough revenue cycle audit should consist of… Medical coding audit Contract performance auditAR auditDenial prevention auditCompliance audit

  3. 1 Coding Report A dashboard for better coding practices Your coding report should: Lists out CPTs, DRG/HCC/APC and the code auditor’s accuracy ratings Surface the dollar differences spotted between payer contracts and reimbursed codes Give clear recommendations for remediation based on audit goals

  4. 2 A complete audit of contracts Seal the cracks 3 point checklist: The contract audit report should consist of a detailed payer matrix It should list out various contract elements Offer data that will help in payer contract negotiation leverage

  5. 3 AR audit- Know the story behind the numbers Know what your AR audit report should consist of: The AR management audit report should examine historical AR valuation activities The AR auditing team should clearly evaluate current AR reserve estimates A concise AR audit report helps revenue cycle managers to identify positive and negative AR trends

  6. 4 Denial audit- Because data matters… Here’s what to look for in your denial audit report: The denial audit should help you to increase denial management efficiency It should categorize denials by denial code/payer/dollar value and other vital denominators Determine the reasons behind untimely follow-ups

  7. 5 Compliance audit Mitigate compliance risks Know what your Compliance Auditor should do: The compliance auditors should perform risk assessment checks and determine the level of risk Check compliance with internal policies/payer guidelines and federal regulations Audit and report the highest risk areas

  8. 1-888-571-9069

More Related