Practice Management Articles

Administration/HR Tips on Selecting a Reputable Billing Company  Customer Service: The Real Competitive Edge  Managed Care Audit Tips and Checklist  Part-Time Work and Job Sharing  Motivating your Employees Keeping Negativity In the Workplace At Bay	Billing How Your State Insurance Commissioner Can Help  Going For the Gold Financial Management Basics Medicare Publishes Billing Edits to Reduce Payment Errors
Clinical Distribution of Sample Medications in the Practice Setting Health Care Quality Standards	Coding ICD-10 Where is it? When is it?  Close "E"ncounters of the Third Kind Incorrect use of Modifer 25 & 59 The Facts About Consultations"What You Need To Know"  Understanding Physician Supervision Levels Inpatient vs. Critical Care Consult Inpatient vs. Critical Care Consult
Collections Timely Tips for Collections  Finance Charges & Sending a Patient to Collection Making Collection Calls the Right Way Letter to the Editor Patient Collections: Retaining Patients, Even When They Owe	Legal & Compliance Reimbursement. Compliance. Overpayments. Auditing The Watchful Eye of the Government – Understanding The Office of Inspector General Work plan Are You "STILL" in Compliance With the "Hazard Communication Standard"? What You Don’t Know About OSHA Can Hurt You New Red Flag Rules to Target Identity Theft New Standards, Versions and Code Set for Electronic Transactions Begin January 2012. Will You Be Ready? Do The New Red Flag Rules Apply to Your Practice? What you need to know about this fast-approaching deadline
Management E-Prescribing plus PQRI could mean 5.5 percent Medicare pay boost in '09 "E" and Earn: Electronic Prescribing Goes Live in '09 Physician Marketing: Educating Current and Potential Patients PMI Certified Professional Shares Tips for Successful Office Management	Miscellaneous Did I Hear What I Think You Said?  Managing When the Stress Doesn't Go Away What Am I, A Machine? Part 1
Patient Relations CUSTOMER SERVICE: The Other Medical Specialty	Reimbursement Dude - Where's My Money?

Managed Care Audit Tips and Checklist 
Linda Dykes

Casting fear into the bravest of managers…"AUDIT NOTICE"!. With proper preparation, any audit can be faced with confidence. The secret is knowing what the auditors will be looking for in the office and your charts. The managed care audit does not focus only on the chart audit; they look into all aspects of the office operation. The auditor will review the physician's updated medical licenses, DEA, DPS and Malpractice Insurance coverage. A site check will include the following areas:

Staffing

Exam/Treatment Patient Care Areas

Appearance and Access

Appointment accessibility

Safety and Emergency Protocols

Medical Record Keeping

Each managed care auditor will have specific forms to follow in these areas. The forms will vary from company to company, but will generally follow OSHA and CMS guidelines. These audits will also vary in specialty; i.e., what is required for an OB will be more detailed than what would be required of an Ophthalmology office. This can be the proverbial "tow birds with one stone". OSHA and CMS office compliance will also cover most managed care audit areas. While the penalties are not in the CMS or OSHA range a general overview and quarterly review should be in your office management protocols.