2022 Gastroenterology Reimbursement and Coding Update: Concrete Solutions to Strengthen Your Foundation in GI Coding and Billing (On-Demand)

Video Transcription

Video Summary

In this video, the speaker discusses auditing best practices in the context of medical billing and coding. They cover topics such as benchmarking, payer audits, and how to respond to an audit request. The speaker emphasizes the importance of paying attention to the date of the audit request and the limited time given to respond, as failure to do so may result in the payer keeping their money. They also highlight the need for providers to be aware of and understand benchmarking for their specialty, and to run reports to ensure they fall within the expected range. Compliance tools and the internal audit process are discussed as ways to minimize the risk of an audit. The speaker provides guidance on how to establish a compliance plan, review internal billing data, and conduct coder training and provider education. They also mention different types of audits, including those conducted by the Office of Inspector General (OIG), Recovery Audit Contractors (RACs), and Zone Program Integrity Contractors (ZPICs). The speaker advises seeking legal representation and taking audits seriously, even if they are routine. They emphasize the importance of providing requested information promptly and accurately, maintaining good documentation, and considering additional supporting materials to defend billing practices. The speaker concludes by urging providers to not accept audit findings at face value and to be prepared to challenge them if they believe they have billed correctly.

Asset Subtitle

Kristin Vaughn, CPC, QMC, QMGC, CPMA, ICDCT-CM

Keywords

auditing best practices

medical billing

coding

benchmarking

payer audits

audit request