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Discussing Audit Findings With Providers: Part 1

Audits may not be the most fun scenarios that your practice can go through, but they are great ways to learn valuable information that can improve your workflow in the long run. Unfortunately, even the most detailed and insightful audit won’t help you make positive long-term changes if there is a disconnect between your providers and the rest of the staff. Physicians and other medical practitioners are great at what they do, but their skills are often focused on diagnostic areas and lacking in the documentation department. As such, it can sometimes be necessary to sit down with them and discuss the results of an audit and what both sides of the equation can do to improve practice efficiency down the road.

To start, resist the urge to make the meeting into an us vs. them scenario. Even if the providers’ documentation is frequently lacking, understand that they spent little if any of their time in medical school reviewing coding and billing. As nice as it would be, very few physicians will ever reach the point where they understand coding and billing as well as those with certifications and years of training. Instead, focus on helping your providers understand what small changes they could make in order to simplify the process for everyone.

In particular, call attention to any audit results that indicate a specific area had more problems than the rest. For example, if there are a high number of evaluation and management (E/M) claims that were denied because they failed to include the encounter time, bring this to the providers’ attention so that they can see how their documentation (or lack thereof) affects people down the line. As long as you present your case in a professional way, the providers should hopefully see what documentation aspects they can can double-check before submitting in order to make the process flow more smoothly for everyone.