E/M Auditing & Consulting
CMS audits have revealed that nearly 42% of claims with evaluation and management codes are billed incorrectly every year. With more changes on the horizon, that number is likely to increase drastically. Vee Healthtek conducts a deep dive into the levels of service coded and billed, ensuring appropriate assignment of CPT codes based on medical necessity, history, physical exams, medical decision-making, and time spent counseling and coordinating care for the patient.
What We Assess:
- Payment integrity audits
- Correct coding audits based on NCCI principles
- E/M level utilization and benchmarking
- Medical necessity audits
How We Deliver Results:
- Retrospective chart review
- Data analysis
- Education and collaboration with administrators and providers to improve workflow (EHR recommendations)
Delivery Recommendations:
- General education for the entire organization/department (recommended annually with regulatory updates)
- One-on-one sessions with physicians to discuss findings
- Small group training
- Education for new providers and habitual offenders
Workflow Process:
- Select documentation to audit
- Categorize audit findings
- Meeting with providers for educational sessions
