| A lawyer’s best friend is a certified legal nurse consultant who also is a certified healthcare chart auditor (CHCA). Medical records/chart auditing is necessary component to risk reduction, compliance and a healthy bottom-line. Auditing provides proof of services rendered by medical providers, and highlights areas that need improvement.
CHCAs have knowledge and experience in the following:
- Knowing what the OIG (Office of Inspector General) is looking for when investigating physicians and facilities through audits
- Auditing and monitoring compliance plans
- Auditing principles and application by dissecting numerous hand-written, electronic, template-driven and other medical record documentation formats
- Interpreting and applying CMS regulations, such as the 1995 and 1997 evaluation & management documentation guidelines
- Understanding regulatory guidelines.
- Understanding quality assurance & risk analysis in addition to scope and statistical sampling methodologies utilized by the OIG
- Applying pertinent regulatory information that is critical to accurate and compliant auditing. Understands the audit process from start to report development and delivery
- Backing up results from a private and regulatory perspective
- Providing education and compliance services to lawyers, physicians, medical providers, insurance companies and healthcare organizations
- Audits Medical Records for accuracy of billed charges
- Meeting with internal and external auditors to compare results and negotiate a settlement
- Reports suspected and confirmed incidents of improprieties to compliance
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Professional Consulting & Educational Services
