Compliance Program Reviews

One of the most important aspects of any compliance plan is the need for recurring chart audits performed by independent outside firms. Decosimo will customize a chart review to specifically meet your needs. A certified professional coder performs all audits. The two major types of chart reviews we perform for our clients are the Comprehensive Reimbursement Review and the On Site Documentation Accuracy Audit.

Comprehensive Reimbursement Review
The Decosimo Comprehensive Reimbursement Review is designed to evaluate medical billing and collection systems. The review begins with the scheduling of patient services and ends with the collection of final payments. Our practice management team scrutinizes every step of the process with minimal disruption of your staff's daily operations. Our initial visit to your practice involves an on-site assessment and the collection of documents to be analyzed at our office. The review culminates in a written report and a personal presentation of our findings and recommendations. Our focus is revenue optimization and compliance. The Comprehensive Reimbursement Review includes an in-depth analysis of these documents:

• Appointment Schedules
• Charge Documents
• Patient Charts
• Chart Notes
• Operative Reports
• Explanations of Benefits
• Patient Account Ledgers

On Site Documentation Accuracy Audit
This audit is performed on site. A total of approximately ten charges for each doctor are randomly selected for review. A list of these charges will be given to office staff with a request to gather the patient office charts and/or copies of any hospital documentation. The accuracy of the level of service chosen by the physician is checked based on the HCFA's Documentation Guidelines and the Tennessee Medicare Audit Form. On the same day as the audit, we will meet with each physician individually to present findings and answer any questions he or she may have.