Question
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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