Has your radiation oncology revenue cycle management fully transitioned to SSAE 16? Developed in 2011 by the American Institute of Certified Public Accountants (AICPA), this new auditing standard replaces SAS 70 to keep pace with the growing acceptance of international accounting standards.
Keeping track of records for errors and omissions may be a burdensome task and sometimes even impossible. And they’re costing your neurosurgery practice more than you realize.
What can you do? Auditing medical charts is the first step and a critical part of any successful radiation oncology revenue cycle management operation. Although chart auditing may seem intimidating for many physicians, there are many positive aspects of chart auditing including increased revenue, treatment efficacy research, and peace of mind in the event of third party audits. With the impact of the OIG, RACs, and other third-party auditors, conducting them the right way is more important now more than ever.
According to the AAPC, there are many reasons why audits, as an integral component of radiation oncology revenue cycle management, are beneficial:
- Determine outliers before large payers find them in their claims software and request an internal audit be done.
- Protect against fraudulent claims and billing activity
- Reveal whether there is variation from national averages due to inappropriate coding, insufficient documentation, or lost revenue.
- Help identify and correct problem areas before insurance or government payers challenge inappropriate coding
- Help prevent governmental investigational auditors like recovery audit contractors (RACs) or zone program integrity contractors (ZPICs) from knocking at your door
- Remedy undercoding, bad unbundling habits, and code overuse and to bill appropriately for documented procedures
- Identify reimbursement deficiencies and opportunities for appropriate reimbursement.
- Stop the use of outdated or incorrect codes for procedures
- Verify ICD-10-CM and electronic health record (EHR) meaningful use readiness
Certified third party independent medical coding and billing services, such as the specialized radiation oncology medical coding, billing and collections services provided by revMD, are essential these days because of all the changes in compliance and audits. revMD has successfully completed an extensive examination, a SSAE 16 (Service Organization Control (SOC)) 1 Type II audit, conducted by an independent accounting firm. The audit examines the effectiveness of internal controls supporting CDS Legal’s e-discovery services.