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Using the coding audit of sample records below, analyze the results and provide a 1-page report of your findings. Your report should: Provide a summary

Using the coding audit of sample records below, analyze the results and provide a 1-page report of your findings. Your report should:

  • Provide a summary of the audit results.
  • Identify potential abuse or fraudulent trends, with examples.
  • Recommend and describe at least one action item based on potential abuse or fraudulent trend.

Claims Audit Report

MR#

Reason for Claims Denial

Physician

MR#39487

Lack of documentation to support code(s) or claim

Dr. Avery

MR#75843

Missing information incomplete form

Dr. Avery

MR#91873

E&M coding discrepancy

Dr. Jones

MR#00282

Missing information incomplete form

Dr. Freeman

MR#44817

Missing information incomplete form

Dr. Smith

MR#11028

Lack of documentation to support code(s) or claim

Dr. Jones

MR#42678

Lack of documentation to support code(s) or claim

Dr. Jones

MR#89234

E&M coding discrepancy

Dr. Jones

MR#12843

E&M coding discrepancy

Dr. Jones

MR#33459

E&M coding discrepancy

Dr. Jones

MR#99087

Lack of documentation to support code(s) or claim

Dr. Jones

MR#51679

E&M coding discrepancy

Dr. Jones

MR#31678

Lack of documentation to support code(s) or claim

Dr. Smith

MR#00925

Missing information incomplete form

Dr. Freeman

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