Physician/Provider Claims Review – Our consultant specialists will validate the billed E/M visit code against the documented encounter note in accordance with current CMS Evaluation and Management Documentation Guidelines. The review will ensure the physician or mid-level provider (NP, PA) has adequately documented the required elements for the key components intended to support the E/M visit code reported. Where applicable, CMS Teaching Physician documentation guidelines are applied to the review. HMI Provides Physician Auditing Services for Documentation, Billing and Coding Compliance Audit and Review Services and Claims Audit.
Physician Office Services – Our consultant specialists will review office and inpatient E/M visits coded and billed, office superbill, office staff policy and procedures, and provide education for physicians/providers (MD, NP, PA) and staff. This review confirm coding and billing compliance with CMS rules and regulations, most current ICD-9-CM/ICD-10-CM diagnosis and CPT© codes are used on office superbill, and staff is performing duties in accordance with office policies and procedures. One-on-one education will be provided to all physicians/providers and if applicable may include designated office staff education. HMI Provides Physician Documentation, Billing and Coding Compliance Audit and Review Services.
Charge Capture – Physician Services – Our coding specialist will review the medical record for appropriate diagnoses assignment and capture E/M levels and/or procedures for billing.
HMI Performs Physician Auditing Services for Documentation, Billing Documentation Audit and E/M Billing and Coding Compliance Audit and Review, Review Physician Documentation Guidelines, Requirements and Improvements.