At Physician Advocates we specialize in Evaluation and Management (E & M) coding audits, RAC audit support, coding training for providers, and compliance and regulatory training and support.
Physician Advocates, L.L.C. is owned and staffed by Medical Records, Coding and Compliance professionals. We specialize in helping health care providers be as effective, efficient and risk savvy as possible.
Physician Advocates can assist you with documentation assessments and training for all types of coding and support for special audit circumstances such as those associated with RACs/MACs.
At Physician Advocates we specialize in Evaluation and Management (E & M) coding reviews and training for providers to insure that providers received the revenue they deserve based on documentation, to assist in clinical documentation improvement, and to provide re-training and risk assessment management. E & M coding accuracy is paramount for health care providers as it drives the effectiveness of the Revenue Cycle Process and reduces Compliance risk.
With the Patient Protection and Affordable Care Act, health care is facing radical changes in reimbursement, in documentation standards, in regulatory scrutiny and in patient expectations. Providers are caught between spending time on patient care, or on trying to keep up with the latest changes in coding and regulations.
Now, more than ever, physicians and providers may find that they do not have the depth of knowledge within their own staff to meet the requirements of running and office and insuring an appropriate and risk adverse revenue stream.
Physician Advocates specializes in auditing for accuracy, documentation effectiveness, risk management and provider productivity.
Physician Advocates can help your practice understand the necessary requirements of appropriate documentation to support your coding and billing functions, prevent and.or mitigate the findings of audits, and help your practice understand the complexities of CMS and other regulatory agencies.
Whatever your practice needs, Physician Advocates will be exactly what you need...an advocate!
Determine the accuracy of current coding methodology
Identify areas where documentation supported higher or lower codes
Identify missed coding opportunities
Assess appropriate use of modifiers
Appropriately capture revenue
Minimize compliance risk
Manage or advise on specialized audits such as those involving a RAC or MAC
Assist in compliance assessments and policy and procedure development for effective compliance programs as required by the NYS Medicaid OIG
Physician Advocates Approach to Your Practice Needs
Our first step is learning about your specific practice. We work for you, so learning about you and your practice is always our first step!
For a normal coding audit, we usually perform an initial assessment on a random sample of between 10 and 20 records per provider (including NPPs), For audits involving RACs or MACs, we will perform a concurrent audit on the same charts requested, and then do a comparison on random audits.
With each assessment we look for accuracy, documentation detail, areas of excellence, and areas in which improvement may be needed. We will compare our findings against national benchmarks, and when requested can provide peer-to-peer comparisons for your practice or group.
For compliance and other risk management activities, we will also work to determine your practice's special requirements, and advise or write your policies and procedures, perform training, and work with you to insure your programs are effective.
Our goal is to insure your practice has an efficient, effective and compliant coding process to insure your drive your Revenue Cycle Management, and minimize your Compliance risk.
Based on our findings and your need, we provide continuing assessments at appropriate intervals, along with ongoing consultative support both on site and by telephone or electronic interface.