CONTACT US TODAY!

Proof of concept audits and auditing services are often available.
Contact Shannon DeConda in our office for more information.

Email: sdeconda@drsmgmt.com -OR- namas@namas.co
Phone: (321)-732-4279

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Average Audit Sample Size

Clients determine the sample size, but often ask for our input.

Most Frequently
Requested Audits

This listing includes the most frequently requested auditing services by our clients in no particular order. We are able to accommodate many other audits and specialties not included in the listing.

 

Evaluation & Management Services

FQHC & RHC Services

HCC & Risk Based Services

Surgical & Procedural Services

Behavioral Health Services

Revenue Cycle Management

Emergency Department & Critical Care

Ambulatory Surgery Center (ASC)

Most Common
Specialties Audited

We ensure specialty diversification to meet our clients needs. Within each specialty, our expertise exceeds the ability to evaluate E&M services, including office based procedures, diagnostics, surgical services, diagnoses, and ancillaries appropriate to the specialty. Our team routinely engages in the following specialities. Client references are always available upon request.

 

Adult & Pediatric Coding & Auditing Services

Orthopedics & Physical Therapy

Dermatology & Plastic Surgery

Cardiology, Vascular & Pulmonary

Urology & OB/GYN

Ophthalmology, ENT, & Neuro

General Pediatrics & Pediatric Subspecialties*

Internal Medicine, Family Practice, & Urgent Care

Emergency Medicine, Hospitalist, Interventionist, Critical Care

*Specific specialties available upon request

TEAM APPROACH

We take a team approach to each project, no matter the size. Each project will have the following team members available to support the project.

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Project Partner

Overall Project Success

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Operations & Admin Assist

Coordinate, assign, schedule and assist with both Client & Team

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Senior Management Auditor

Daily project tasks and timely deliverables. 15 years of audit experience

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Staff Audit Support

Project support as needed based on specialty, with QA oversight. Minimum of 5 years specialty experience

A deeper look at our auditing services

A coding audit is a comprehensive review of your coding, billing, documentation and reimbursement process. Who better to perform your coding audit than the only nationally recognized trainer of medical auditors; NAMAS.

NAMAS auditors are dually credentialed as Certified Professional Medical Auditors (CPMA) and Certified Professional Coders (CPC) and each auditor has a minimum of 15 years’ experience. Our auditors perform more than 2000 unique coding and compliance audits annually for medical practices and facilities around the country and overseas.

The reason for performing a coding/documentation audit is compliance. An annual review of your practice’s coding and documentation is recommended by the OIG (Office of Inspector General) as part of an effective compliance program. A coding audit can help ensure that you are receiving appropriate reimbursement for all the services you provide. In addition, a coding audit will help:

  • Identify areas of risk leading to over or under coding and documentation
  • Ensure that your coding practices are compliant with the regulations set forth by private and government payors
  • Teach your providers and staff how to use documentation to maintain compliance and proper reimbursement

Coding audits can be performed remotely or at your location. A NAMAS auditor will review a random selection of charts to identify trends in your coding practices that may be costing your practice money or putting your practice at risk. Our comprehensive coding audits include an evaluation of the practice’s fee schedule, modifier usage, CPT/ICD coding, provider documentation, EOB denial trends, and productivity levels for Bell Curve analysis. Your NAMAS auditor is proficient in the rules and regulations enforced by Medicare and commercial payors. Your NAMAS auditor will also identify coding and billing practices that could increase efficiency and overall revenue.

Implementation is critical and your NAMAS auditor will recommend best practices and how to correct identified deficiencies detected during your review. Therefore, it is most important that the audit findings are discussed and reviewed in detail with each provider, including physician assistants and nurse practitioners. Education to ensure improvement of the noted deficiencies is paramount to the overall success of the audit. Our auditors will communicate the methodologies used during your audit. A NAMAS auditor will also spend time with each key staff member such as medical and surgical coders to provide hands-on training and feedback to ensure they are equipped to assign the most accurate codes that are in the best interest of the practice.

To inquire about auditing services for your organization, please email namas@namas.co or use the form below.

Contact us today to discuss your audit plan



    Communication Preference