Auditing

No two businesses are alike, so MediQuick provides a wide range of auditing services to meet the needs of your business or organization. We pride ourselves on developing productive and lasting relationships with our clients by customizing audits to fit your needs and remain within budget.

Many clients want annual provider audits in support of a corporate compliance plan –

• A selection of 5 to 20 records per provider are reviewed for accuracy in CPT®, HCPCS and ICD-10-CM codes.
   
• Pass/fail audit thresholds are determined by the client’s compliance policies.
   
• Based on client policy, providers who fail their audits receive education on the aberrances within a 30-day period.
   
• After education and time for application, the provider is re-audited with new dates of service.
   
• Once a passing accuracy score is reached, the provider will return to annual audits.

Audit projects offer insight into a specific area of risk and determine the need for additional corrective action –

• High-risk CPT® codes
• Internally-identified outliers
• Preparation for response to CMS probe audits
• Onboarding new providers
• OIG Work Plan maintenance

Reports are inclusive with every audit; however the type of reporting will be determined by the client.  We offer several options which include dashboards, detailed education reports, regulatory references, executive summaries, and claims correction reports.  Each client is served based on their individual needs and budget allowance.

A sample of our audit specialty areas:

• Surgeries – all specialties
• Radiology
• Primary Care
• Internal Medicine
• Hospital Medicine
• Pre-bill Claims Review
• Hierarchical Condition Category (HCC)
• CMS Targeted Probe and Educate (TPE)
• CMS Recovery Audit Contractor (RAC)

Please contact us to discuss your goals, and together we can create the perfect solution for you!

MediQuick Physician Services is also OIG-approved to act as an Independent Review Organization (IRO) to meet the need of those under a Corporate Integrity Agreement (CIA).