What do you mean by medical auditing?
Medical auditing is a process used by health professionals to assess, evaluate and improve care of patients in a systematic way. Audit measures current practice against a defined (desired) standard. It forms part of clinical governance, which aims to safeguard a high quality of clinical care for patients.
Key features of audit are:
- Audit asks the question: ‘Are we actually doing what we believe is the right thing, and in the right way?’ (unlike research, which asks ‘What should we be doing?’).
- Audit can be used to evaluate various aspects of patient care:
- Structure of care – eg, the availability of a smoking cessation clinic in a locality.
- Process of care – eg, waiting times for an appointment at the smoking cessation clinic.
- The outcome of care – eg, the number of smokers who quit smoking for one year.
- Audit should be transparent and non-judgemental. The aim is to find out how the present provision compares with the desired standard. This information can then be used to plan improvements in the service. It is not intended to cause confrontation or blame.
To cut it short, it’s just double-checking and making sure what is being coded is accurate and you have all these computer programs and audit tools you can use during the process.
What does a Certified Professional Medical Auditor (CPMA) do?
The goals of an audit are to provide efficient and better delivery of care and to improve the financial health of your medical provider. Medical record audits specifically target and evaluate procedural and diagnosis code selection as determined by physician documentation. Once areas of weakness are revealed through an audit, you can present the audit findings and identify opportunities for training in your health care organization. Source: https://www.aapc.com/medical-auditing/medical-auditing.aspx
They will also review and audit medical coding data. Corrections to this data will also be made by the medical coding auditor. When medical coding assignments seem wrong and mistakes seem to be repeated, the auditor may have to report this to management, or he or she may have to make inquiries to the department that had created the documentation. Feedback is also given on performance results. The auditor may also be required to provide training and education.
In a nutshell, a medical coding auditor:
- Contribute to the development of codes for patient billing.
- Conduct analyses to evaluate the accuracy and efficiency of coding practices.
- Review the work of coding clerks to verify accuracy of coding and that patients are billed correctly.
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Medical Auditing Salary
According to PayScale, most medical coding auditors in the United States are women. The median pay for people in this role is approximately $54K annually. Pay generally varies between $34K and $74K per year. Residence is the biggest factor affecting pay for this group, followed by years of experience. Most report receiving medical coverage from their employers and a strong majority collect dental insurance. The majority of Medical Coding Auditors claim high levels of job satisfaction. Source: http://www.payscale.com/research/US/Job=Medical_Coding_Auditor/Salary