Comprehensive compliance audit services
We aim to provide you with services that will free you to devote more time to caring for your patients. While you go do that we will ensure to reduce denials, follow regulatory compliance and increase revenue. All this would be done in compliance with payer and Government rules and regulations.
Our chart audits features a detailed analysis of historical charts, related documentation and trends in reimbursements. Using coding methods, we identify patterns and tendencies. This is followed by a detailed report of the findings. We also provide recommendations and cross-references regarding the best practices in the industry and specialty.
The code compliance process
We provide fool proof solutions to audit medical claims leveraging a combination of validated audit practices, expert professionals and most definitive analytics technology.
I have been a very satisfied client with Practolytics for nearly 5 years now. As you would expect, they are collecting the money that we have worked so hard for. We like the fact that they share our passion for data. We both approach our common issue i.e., how to collect money from a data centric viewpoint, and this drives improvement. The team is always willing to listen to us and make changes if necessary. Through the years we have asked for help with various office activities from credentialing to prior authorizations to procurement of outside medical records. Yes, these were add on-services, but outsourcing these activities to their team has been a winning solution that has intertwined the billing team into the success of our practice. These add ons have been a good value for us too. Lastly, we have easy access to one of the principal partners on the billing team, and the response time has always been excellent. Thank you! Practolytics!
It’s a great pleasure to write a letter of recommendation for Practolytics and its staff. I am extremely pleased with the quality of services and knowledge they provide to our clinic. Our group practices in Central Florida and we have been with Practolytics since 2014. I am fully confident that our claims are submitted efficiently, information is inputted accurately, and attention to detail will always be a priority.
We are a solo orthopedic practice in North Carolina and our relationship with Practolytics started in June 2015. They have staff members who are always willing to help. They work very hard to make us happy and I appreciate all that they do on a daily basis. They take out the worry of getting payments and always follow up with insurance companies. I found the customer service to be unsurpassed. All phone calls are returned and our questions are answered in a thorough and timely manner. The monthly reports are easy to read and provide a quick assessment of the health of the practice, including the company’s account receivables. When I need advice or am unsure of something, it gives me comfort to know that they are just a phone call away. Switching to Practolytics was truly one of the best decisions that I have made for our practice. I truly look forward to a longtime relationship with the staff at Practolytics.
Our experts work to improve your process efficiencies & rectify errors
At Practolytics, our subject matter experts ensure that we deliver a seamless user experience and process correctness all across the RCM modules.
We conduct audits of end-to-end revenue cycle processes including code assessment, billing information, charge capturing, data transfer protocols and related documentation to identify and fix errors and inefficiencies.
What we promise to do for your Revenue Cycle Management?
FAQs about Compliance Audits
What is a compliance audit in medical RCM?
It is the process of assessing historical & current claims and ensuring that claims are submitted in compliance with Local and National Coverage Determinations and payer-specific guidelines(LCD).
What are the different phases of the audit process?
There are four main phases of the entire compliance audit cycle. They are Preparation, Performance, Reporting & Follow-up.
Why do we use encrypted emails and password protected attachments?
Encryption of emails protects the contents of the email and the content of the attachments when it reaches unintended recipients. We mandate emails to be encrypted and passwords to be protected in our organization as increased security and compliance measures.
Why is it necessary to record the payer denial code/reason on the patient’s account in the billing system?
It is an appropriate audit trail. It ensures appropriate follow-up action is taken. It tracks and establishes trends of potential billing and/or coding problems. This report can be utilized for account analysis as well.
How can we get our doctors to follow documentation guidelines?
Education, feedback and more education. You must be persistent and follow through to show your commitment. We audit doctor’s medical records and any inconsistency is taken as an education source to educate physicians.
If someone other than the physician documents the history, ROS, medical, social, family history, can I use it when determining the level of E&M cpt?
You can use the ROS, past medical, social & family history. The provider’s documentation should support that they reviewed the ROS and PFSH documented by the ancillary staff. The history of present illness needs to be taken and documented by the physician.
How often do employees need compliance training?
Employees working in various healthcare roles, including coding and billing, should be trained in appropriate areas (HIPAA, HITECH, etc.) immediately upon hire and at least annually thereafter. Employees should be trained when existing regulations change or are updated and when new regulations are put into place. Our experienced training team ensures this is being followed to all our employees on board.
What resources are used as compliance reference resource?
Resources that included for references are: OIG, the Centers for Medicare & Medicaid Services, the U.S. Department of Health & Human Services, and AAPC. These organizations provide informational articles, auditing software, news about updates and alerts, compliance ideas, and more.