What is medical auditing?
What is medical auditing?
Medical auditing is a thorough assessment of coding and billing information to validate accuracy and compliance within a healthcare organization. Most audits look at components of payer reimbursement processes to evaluate compliance with payer guidelines as well as federal and state regulations. The medical audit serves a vital role in a healthcare organization to ensure both risk mitigation and quality revenue cycle management.
What are the different types of medical audits?
There are two primary types of HIM medical audits. External audits identify compliance issues and areas in which to improve performance. External audits also determine education needs within an organization. Internal audits identify areas of weakness within the coding and billing staff so that focused education can be provided.
What are the benefits of a medical audit?
- Identify errors in coding and billing, including under coding, upcoding, unbundling, and incorrect use of modifiers.
- Identify fraudulent billing practices, both intentional and nonintentional
- To establish an effective quality assurance process to onboard new coders and providers
- To identify and provide focused education on missed opportunities and other areas of strengths and weaknesses
- To address areas of risk to prevent Risk Audit Contractor (RAC) or Risk Adjustment Data Validation (RADV) investigations
- To improve patient quality of care and help improve safety measures
Does Intellis hire medical auditors?
Yes! See our open positions here.
Does Intellis offer medical auditing services?
Yes! Check out Intellis IQ medical auditing services.
Intellis offers HIM and revenue cycle services. Please see our suite of Health Information Management Services and Revenue Cycle Solutions.
Intellis offers AHIMA-approved CEUs.
The Intellis IQ Education Center offers coding and clinical documentation continuing education approved by AHIMA. Please contact us if you have questions about our education platform and how it helps individuals and organizations.
What is medical coding?
Many people ask, “what is medical coding? Medical coding is the translation of healthcare diagnoses, procedures, medical equipment, and medical services into one of several universal coding classification systems using either alphanumeric or numeric codes. Codes for healthcare diagnoses and procedures reflect the information in patient medical record documentation to facilitate reimbursement and provide analysis of patient outcomes and research. Quality medical coding has many positive downstream effects. Studies show that accurate and complete coding for patients’ chronic diseases or conditions results in better care.
Medical coding is also critical to provider organizations working under risk-based contracts. Research indicates improved financial performance for the organization when patient treatments, services, and supplies are accurately and completely coded.
What do medical coders do?
A medical coder, also known as medical records and health information technician, is essentially a translator. The medical coder reviews patient files and translates procedures, diagnoses, and services into a code that healthcare providers and insurance companies utilize. Medical coders require critical thinking skills and a thorough knowledge of medical terminology, anatomy, pathophysiology, and pharmacology.
How long does it take to become a medical coder?
Though medical coding certification depends on several factors, the path to becoming a medical coder generally takes nine to two years to complete.
Does Intellis hire medical coders?
Yes! See our open positions here.
Does Intellis offer medical coding services?
Yes! Check out Intellis IQ coding services.
Intellis offers HIM and revenue cycle services. Please see our suite of Health Information Management Services.
Intellis offers AHIMA-approved CEUs medical coding.
The Intellis IQ Education Center offers coding and clinical documentation continuing education approved by AHIMA. Please contact us if you have questions about our education platform and how it helps individuals and organizations.