2024 Gastroenterology Reimbursement and Coding Update | November 2023-Auditing Physicians and Advanced Practice Providers in Your Practice

Auditing Physicians and Advanced Practice Providers in Your Practice

Video Transcription

Video Summary

In this video, the speaker discusses provider audits and provides tips for educating providers on coding and billing issues. They emphasize the importance of communication and not assuming that providers have extensive coding knowledge. They mention different types of payer audits, such as those conducted by the Office of Inspector General, recovery audit contractors, and CERT audits. The speaker advises conducting internal audits to ensure compliance when receiving a letter from an insurance company. They also talk about benchmarking and comparing a provider's use of each level of service to national averages. The video covers topics such as modifier 25, modifier 59, cloned records, and the correct use of billing codes. They also discuss responding to audits and the importance of reading and understanding audit letters, providing requested information, and consulting with an experienced health law attorney if necessary.

Asset Subtitle

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

Keywords

provider audits

educating providers

coding and billing issues

payer audits

compliance