Audit Preparedness and Response
Enhanced audit readiness while mitigating risk and safeguarding your organizations financial health.
Charted Care provides expert medical billing audits and independent professional opinions to ensure accurate and compliant coding for healthcare providers. By analyzing claims files and corresponding medical records, we identify potential discrepancies and help physicians verify correct billing practices. With Charted Care, healthcare professionals gain the confidence of accurate billing, reduced compliance risks, and optimized patient care.
Our Services
Proactive Audit Response
Proactive audit preparedness is crucial in preventing potential compliance issues before they arise. Our proactive services include:
Compliance Training
We offer tailored training programs for your staff to ensure they understand CMS regulations and are equipped to maintain compliance.
Internal Audits
Our team conducts thorough internal audits to identify and rectify potential issues, ensuring your documentation and claims are accurate and compliant.
Documentation Support
We assist in creating and maintaining meticulous records, enhancing your ability to respond to audits with confidence.
Risk Assessment
Lack of training on CMS regulations can lead to unintentional compliance breaches. Regular training programs are necessary to keep staff informed of changes in regulations.
Responsive Audit Response
When audits occur, our reactive services are here to help you manage the situation effectively. Our responsive services include:
Audit Preparation
We prepare your organization for the audit process, ensuring all necessary documentation is in order and accessible.
Response Development
Our team crafts detailed responses to audit inquiries, addressing findings and providing supporting documentation to resolve issues promptly.
Appeals Assistance
If you receive unfavorable audit results, we assist in preparing and filing appeals to contest unjust findings.
Ongoing Support
We provide continuous support throughout the audit process, guiding you every step of the way to ensure a smooth resolution.
Charted Care
Why Choose Us?
Our team consists of seasoned professionals with extensive experience in Medicare and Medicaid regulations and audit responses.
Expertise
Our multifaceted approach allows us to engage the full scope of services including legal, clinical, and billing professionals to achieve the most favorable outcomes for our clients.
Personalized Approach
We tailor our services to meet the unique needs of your organization, ensuring effective and efficient audit management.
Commitment to Compliance:
We are dedicated to helping you maintain compliance, reduce the risk of audits, and safeguard your organization’s reputation.
For Context
What are the most common compliance issues healthcare organizations face with CMS regulations? Healthcare organizations often encounter several compliance issues related to CMS regulations.
Here are some of the most common challenges:
Documentation Errors
Inadequate or incorrect documentation can lead to denied claims or
penalties. Ensuring that patient records, billing information, and treatment plans meet CMS
standards is crucial.
Billing and Coding Compliance
Incorrect coding for services rendered can result in improper billing and potential audits. Organizations must stay updated on coding guidelines and ensure accuracy in claims submissions.
Quality of Care Standards
Compliance with quality measures set by CMS is essential. Failure to meet these standards can result in penalties and reduced reimbursements.
Employee Training and Awareness
Lack of training on CMS regulations can lead to unintentional compliance breaches. Regular training programs are necessary to keep staff informed of changes in regulations.
Provider Enrollment Issues
Failure to maintain accurate and timely provider enrollment can lead to payment disruptions and compliance violations.
Audit Readiness
Many organizations are not adequately prepared for audits, leading to difficulties in responding to CMS inquiries and potential financial repercussions.
Patient Care Coordination
Ensuring compliance with care coordination requirements for Medicare beneficiaries can be challenging, particularly for organizations managing complex patient populations.
Data Reporting and Submission
Accurate and timely reporting of required data to CMS is essential. Errors or delays can result in penalties and affect reimbursement.
By addressing these common compliance issues proactively, healthcare organizations can better navigate CMS regulations and reduce the risk of audits and penalties.