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