Documentation & Coding Audit Services
Our documentation and coding audits are designed to identify coding and documentation issues that may affect reimbursement and/or raise compliance risks. Through a comprehensive assessment of documentation, coding and billing practices, our recommendations are intended to help providers take appropriate corrective action and ensure compliant practices. GHA offers a variety of audit services and approaches to suit the needs of your organization, including:
PROFESSIONAL PHYSICIAN SERVICES
HOSPITAL INPATIENT SERVICES (INCLUDES HOSPICE, SNF, LTC, BH, OBS)
HOSPITAL OUTPATIENT & ASC SERVICES
EMERGENCY DEPARTMENT PROFESSIONAL /FACILITY
TELEHEALTH & REMOTE PATIENT MONITORING SERVICES ***
CODER & AUDITOR QA
RISK ADJUSTMENT / HCC
MEDICAL RECORD CONSULTANT PROGRAM
GHA will help your organization determine the most strategic and efficient approach for its audit and compliance needs. We routinely work with attorneys to prepare deliverables under the attorney-client privilege, which ensures that our clients have the benefit of legal expertise to help navigate complex situations. All GHA auditors have a minimum of five (5) years of coding and audit experience, and are required to be Certified Professional Coders (CPCs), Certified Risk Adjustment Coders (CRCs) and Certified Professional Medical Auditors (CPMAs). Our auditors also undergo rigorous pre-employment testing and ongoing monthly qualification reviews.
In order to ensure quality control of each project, GHA matches the expertise of the coder or auditor to the medical specialty under review. In addition, we utilize a two-tier review process: after the primary audit is completed, the results are sent for a secondary review by a senior auditor. This provides a multi-layer review to help ensure that audit findings are complete and accurate. GHA also has the ability to create a variety of custom reports to suit your organization’s needs.
Depending on the type of engagement, audit deliverables typically consist of the following:
GHA will work closely with leadership to facilitate completion of the project and schedule a time to review deliverables.