Not conducting chart reviews on a regular and consistent basis

The 8^th common mistake in managing cash flow is due to the lack of chart reviews / audits.

A BDA coding review includes taking a thorough look at the documentation of each particular visit to ensure that the appropriate level of the ED code was billed along with any other billable services. We perform chart reviews for our clients either quarterly or twice a year. Again, this is an item that is frequently shuffled off to the side because of the hectic daily schedules of running an Emergency Department.

BDA Coding reviews include:

Documentation of the entire encounter; the physicians notes, the nurses notes, and any of the ancillary documentation that corresponds with each visit.

The corresponding fee ticket. The fee ticket is important because it indicates what services are being captured by the provider/staff or not being captured by the provider/staff for charge processing.

The corresponding claim forms. The claim form identifies which charge elements are actually being submitted or not being submitted to the outside world for payment. Often there are numerous issues that can be identified from this type of review. One issue that might be identified would be charges that actually do not match the encounter documentation. A second issue that might be identified would be that there are billable services that are not separately charged for. A third issue would be incorrect information in the charge master. A forth issue would be duplicate billing from different departments. This is identified by different revenue codes representing the same service. A final issue that might be identified in a claim form review would be incorrect utilization of modifiers in and units.