AUDITING SERVICES & CHART REVIEWS
We Provide Auditing and Chart Review Services for Organizations of Any Size and Specialty
Expert Audit Services and Chart Reviews Across Many Specialties
Our team at has deep specialty expertise to fulfill your needs. Within cardiology, orthopedics, oncology, and other specialties, we exceed industry standards in evaluating office visits, procedures, diagnostics, surgery, diagnoses, and ancillary services. Our experts routinely review claims across a range of specialties to ensure appropriate services are provided. We especially take pride in our ability to thoroughly evaluate E&M services and meet our clients’ requirements.
Adult & Pediatric Coding & Auditing Services
Orthopedics, Rheumatology & Physical Therapy
Dermatology & Plastic Surgery
Cardiology, Vascular and Pulmonology
Urology, Oncology & OB/GYN
Ophthalmology, ENT, & Neurology
General Pediatrics & Pediatric Subspecialties*
Internal Medicine, Family Practice, & Urgent Care
Emergency Medicine, Hospitalist, Interventionist, Critical Care
Our auditors have experience spanning decades, and we collaborate closely to ensure we’re providing the highest level of service on every engagement. I’m proud to be part of a team that goes above and beyond for our clients when it comes to specialized auditing and clinical chart review.
Alicia Scott, CPC, CPC-I, CRC
Popular Types of Audits
Our most popular auditing services, requested frequently by clients, include the following – though this is not an exhaustive list. We’re able to conduct audits across a wide variety of other specialties and areas not mentioned here, so please reach out if you don’t see what you need. The services below represent some of our most commonly requested audits, but we’re flexible in accommodating many other needs our clients may have.
- Surgical & Procedural
- HCC & Risk Based Services
- FQHC & RHC Services
- Evaluation & Management Services
- Ambulatory Surgery Center (ASC)
- Emergency Department & Critical Care
- Revenue Cycle Management
- Behavioral Health Services
Why Audits & Reviews Are Essential for Healthcare Organizations
In the fast-paced and complex world of healthcare, proactively identifying and addressing potential coding and documentation issues is crucial for maintaining compliance, ensuring accurate reimbursement, and safeguarding the integrity of your organization. Regular audits and reviews serve as a valuable tool to achieve these goals and provide a range of benefits, including:
- Proactive Approach to Compliance: Audits and reviews help identify areas of risk and potential coding errors before they lead to costly audits or investigations by regulatory agencies. This proactive approach allows for timely corrective action to prevent further issues and protect your organization’s reputation.
- Performance Improvement: Audits and reviews provide valuable insights into coding practices, documentation standards, and billing procedures. These insights can be used to identify areas for improvement, enhance staff training, and streamline processes, leading to overall performance optimization.
- Regulatory Compliance: Audits and reviews ensure that your organization’s coding practices align with the ever-changing regulations set forth by private and government payors. This compliance helps avoid denials, audits, and potential penalties, safeguarding your organization’s financial well-being.
- Effective Compliance Program: The Office of Inspector General (OIG) strongly recommends annual coding audits as a key component of an effective compliance program. These audits demonstrate your commitment to accuracy, transparency, and ethical practices, fostering trust with stakeholders.
- Staff Education and Training: Audits and reviews provide opportunities to educate and train staff on proper coding and documentation practices. This training empowers your team to maintain compliance, improve billing accuracy, and minimize the risk of errors.
Regular audits and reviews are essential for healthcare organizations to navigate the complexities of coding, documentation, and billing. By proactively addressing potential issues, enhancing compliance, and optimizing performance, you can ensure the long-term sustainability and success of your organization.
The CCO 6-Step Audit Review Process
A discovery call is booked. This call allows us to gain a mutual understanding of your organization’s needs, the scope of work, and the desired outcomes. During the call, we will gather information about your organization’s coding and documentation practices, identify any areas of concern, and discuss potential solutions and next steps. This informal call is typically 30 minutes long.
scope & Agreement
CCO presents a comprehensive written Scope of Work outlining training details, responsibilities for both the Client and CCO, and other pertinent project information. Additionally, a detailed agreement is provided, specifying pricing considerations and various options to suit the Client’s needs as well as a BAA agreement to ensure proper compliance.
To ensure a successful project kickoff, the assigned trainer will schedule an introductory call to discuss the event’s schedule and, more importantly, to finalize the agenda’s content. Ideally, we will review the specifications with those directly involved in day-to-day operations. This collaborative approach ensures that the project specifications align seamlessly with your actual requirements and expectations.
We begin the Audit and Chart Review process and patient records are meticulously reviewed by accessing them through secure, HIPAA Compliant data exchange mechanisms or by directly accessing the electronic medical records (EMR) system. The completion timeline varies by the project size. For example, a 10-provider documentation audit review can be completed within a timeframe of ~30 business days.
Post-audit debriefing is an essential step in the audit review process, providing a valuable opportunity to discuss findings, identify areas for improvement, and implement corrective actions. Our team will collaborate closely with your organization’s budget coordination, compliance operations, and provider management teams to thoroughly review audit findings and recommend best practices for addressing any identified deficiencies.
While individual projects vary, CCO prioritizes provider feedback as an integral part of the audit review process. Without feedback, an audit is merely a formality. To facilitate feedback collection, CCO optionally offers both group and individual training sessions tailored to your needs. This streamlined approach ensures all providers can actively participate and contribute to the audit’s success.
A post-audit debriefing provides the perfect forum to transform an audit into an opportunity. By taking a deep dive into the findings with an organization, we can have candid discussions to uncover the root causes and systemic gaps. This paves the way for targeted solutions to improve policies, training, and operations. Our goal is to partner with teams to leverage the audit insights to build a stronger, more audit-ready organization.
CPC, CPC-I, CRC, CCO Education Director
Book Your Discovery Call Today
Select a time from the calendar below.
Frequently Asked Questions About Auditing and Chart Review
As recommended by the Office of Inspector General (OIG) and mandated by many state Medicaid plans, annual audits or reviews are the standard practice for healthcare organizations.
While an official time interval is yet to be determined, the Federal Register currently indicates that performing a coding and audit reviews “is a requirement” for healthcare organizations.
We respect your professional time and plan to keep the discovery call to approximately ~30 minutes or less.
Yes, we work with Accountable Care Organizations (ACOs) of all sizes and have auditing and chart review services to meet your needs.
Yes, we work with Federally Qualified Health Centers (FQHC) and are able to meet your budgetary demands with innovative solutions.
Yes, we can also work with a private physician and specialty office consisting of a single or few providers. Our unique auditing solutions can ensure you’ll receive the most competitive cost with exceptional value.