Audit Hot Spots For Emergency Medicine
Documentation And Correct Coding Are Key In Avoiding Costly Audits.
Use of electronic medical records may increase risk of inaccurate and/or incomplete statements; inadequate pre-billing audits may increase claim errors that are being identified on payer audits; increasing incentives for whistleblower claims increase vulnerability. That means, payer audits are increasing.
Our speaker, Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, will walk you through common problems, solutions and ways to audit records and improve audit outcomes. You’ll understand how your internal audit processes can catch errors before claims go out. She’ll present examples of records from actual audits with explanation of how problems occurred and how they can be addressed on appeal. And remember, appeals and rebuttals must address coding issues AND medical necessity/patient risk factors equally.
Here's a glimpse at some of the issues Caral will address:
- Controversial elements of Emergency Medicine Coding
- Can you combine all elements of the history in the HPI? Some payers say “NO” – How do you document to assure you address all you do
- Review of Systems – all other systems reviewed and negative – Does this count? Some payers say “NO”
- Interpretations of Diagnostic Studies (EKG/Rhythm Strips/Xray) and their vulnerability when audited
- Split and Shared Services; What payers are looking for on audits
- New information on documentation requirements when using scribes
Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.
Who should attend? ED Physicians; ED Coders; ED Auditors; Compliance Directors, Revenue Managers; Billing Managers
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- Dreama Sloan-Kelly, MD, CCS
- Margie Scalley Vaught, CPC, CPC-H, CPC-I, CCS-P, PCE, MCS-P, AC
- Thomas Force,
- Jim Sheldon-Dean,
- Wayne J. Miller, Esq.
- Kim Garner-Huey, MJ, CPC, CCS-P, PCS
About Our Speaker
Caral Edelberg, CPC, CPMA, CAC, CCS-P, CHC, is President of Edelberg Compliance Associates, Baton Rouge, LA. Caral is Consulting Editor of Hospitalist Coding Advisory, a monthly newsletter for hospital medicine physicians and coding staff and is the author of “Hospitalist Desktop Reference”, a coding and documentation guide for hospitalists.
She is a past member of the Advisory Board of the American Academy of Professional Coders (AAPC); past president Baton... More Info
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