Services

Chart Auditing

Since 1998 PMG has completed tens of thousands of chart audits and medical record reviews for CHC clients, with a focus on evaluation and management (E&M) and ICD documentation.

E&M Chart Auditing

With intensified Medicare and Medicaid scrutiny — as well as recovery audit contractor (RAC) work expansion — CHCs will continue to be evaluated to see if their documentation supports the level, scope and breadth of billed services.

Evaluating individual dates of service, PMG's certified coders score the SOAP documentation and other potentially billable services to determine whether a provider's documentation is too high, too low, a match or even "uncodable" based on federal E&M documentation guidelines.

Note: E&M chart auditing is an included service for our CHC billing clients and available for independent purchase by our consulting clients.

ICD-10 Chart Auditing

In preparation for the transition to ICD-10, PMG provides ICD-10 chart auditing services for CHCs. Many experts call this transition one of the most significant changes in health care in over 30 years. The implementation of ICD-10 will have a far-reaching impact on areas including front desk, billing software, provider training and reporting.

Although October 2013 might seem far away, ICD-10 preparation can't wait. While awaiting publication of final ICD-10 rules, PMG will be readying our certified coding staff in optimization of ICD-10 for our billing/revenue cycle management and consulting clients.

ICD-10 preparation requires training providers on correct and optimal ICD-10 coding. However, being certain the codes selected are accurate is another compliance initiative and revenue enhancement opportunity on its own. PMG's certified coders can review records and assess accuracy to make sure revenue is optimized in addition to mitigating negative outcomes resulting from RAC or other payer audits.

While avoiding fines and penalties is secondary to assuring coding is optimal and accurate, minimizing or eliminating payment recovery of any kind will be critical as Medicaid RACs begin their work in January 2012.

Note: ICD-10 chart auditing is an included service for our CHC billing clients and available for independent purchase by our consulting clients.