Medical Practice Audits: Preparing for What's to Come

I posted last time about being under scrutiny. I wrote about following the rules, however we may feel about them. Well, talk about scrutiny: I have recently been informed that our office has randomly been chosen for chart audits -by two insurance companies.

When we got the letter from the first company, it was a surprise, but not a complete shock. They do send out letters beforehand letting you know that the practice may be contacted for an audit.

Then there was the matter of pulling charts. Well, we have an EHR, so there really is nothing to “pull.” They want to audit 40 charts. The idea of printing out a years worth of clinical information for 40 patients had me concerned about the staff time, paper, and toner it would take, not to mention the duration of time that our printer would be occupied. The person from the auditing company asked if we are “USB-compatible”. What? I didn’t know. It had never come up before. So we tentatively scheduled the audit for printing and scanning. I called my value-added reseller (the local vendor and support team) and was told that they could install a virtual printer and could save the files that could then be copied onto a flash drive. Again, what? I had no idea what that would entail. It turns out, that is pretty simple. The virtual printer is installed, a folder was created into which the charts can be saved, and according to the auditor, they’ll do that when they get here.

Ah, and then the second letter came, from another insurance company; same deal. Thankfully, it is for fewer patients.

I have been assured that all they will need is space for a laptop and access to the system. Apparently, they don’t need me, they don’t need my staff. We’ll see. It will apparently take them a whole day to do this. I can only hope it doesn’t disrupt our work flow.

I guess that should be the least of my worries. What will they find? I can’t imagine anything bad. I am hoping they don’t decide that they need to down-code, and that we need to reimburse them. I hope they don’t decide certain things weren’t medically necessary. Apparently, sometimes it doesn’t pay to be thorough. There’s not a whole lot I can do about it now. What’s charted is charted. I’ll cross my fingers and hope it all works out.

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