Posted and filed under Careers, Medical Record Auditing.

Advantages to Utilizing an External Auditing Firm

External auditors, or auditors who work for external auditing firms, are often trained in a variety of specialties and have experience in auditing for many different payers, providers, and facilities. Hiring an external auditor is extremely advantageous because they are equipped with knowledge and experience that allows them to not only identify problems, but to…

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Posted and filed under Coding, Compliance, Medical Record Auditing.

Advize Health Meaningful Use and Security Risk Analysis Webinar Recap

On March 10, Advize Health held our fifth monthly webinar on Meaningful Use and Security Risk Analysis. For this webinar, Advize Health’s auditor Melissa Jewett presented with Don Waechter from Compliance and Remediation Services, LLC. Both Melissa and Don are highly qualified to deliver such an informative webinar; as Melissa is a Certified Professional Coder…

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Posted and filed under Medical Record Auditing.

The Importance of Medical Necessity in Medical Coding

Medical necessity documentation, or lack of it, is one of the most common reasons for claim denials. For a service to be considered medically necessary, it must be reasonable and necessary to diagnosis or treat a patient’s medical condition. When submitting claims for payment, it is the diagnosis codes reported with the service that tells…

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Posted and filed under Medical Record Auditing.

Front Lines vs. Behind the Scenes in the Medical World

The work performed by Advize Health is enacted with insurance providers and patients in mind. Protecting providers and patients from fraud, waste, abuse, and unnecessary use of money are among our priorities, and our team of auditors works hard to deliver the best results.   Every facet of coding and auditing is important, because the end…

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Posted and filed under Coding, Medical Record Auditing.
claims data

Auditing Claims Data: What Can The Data Tell You?

There are many techniques to extracting data that can range from reviewing claim line billing data to actual medical record reviews. Relying exclusively on the claims data to analyze and identify atypical billing patterns or potential red flags is always challenging. As auditors we all know that the value of the audit process is only…

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Posted and filed under Medical Record Auditing.
Posted and filed under Medical Record Auditing.

The Benefits of DRG Validation

DRG validation is a tool that can be used to reduce risk, defend claims, and ensure the accuracy of the coded items. The purpose of DRG validation is to confirm that diagnostic, procedural information, and the discharge status of the beneficiary, as coded and reported by the hospital on its claim, matches both the attending…

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Posted and filed under Coding, Compliance, Medical Record Auditing.

Vaccine Administration Counseling

Vaccine administration coding and documentation is often confused by many providers, billers, coders, and even auditors.  One misunderstanding is what exactly is a toxoid component? And what documentation is necessary to support billing vaccine administration with counseling?  Here’s a quick look at the codes we are talking about. A toxoid component according to CPT refers…

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Posted and filed under Careers, Coding, Medical Record Auditing.

Why you Should Consider a Career as an Auditor

As Advize Health continues to hire part-time and full-time remote Auditors, we felt it necessary to inform you of the reasons why you should consider a career in auditing and its benefits. Some of the perks you can enjoy as an auditor at Advize Health include: Free education with CEU’s provided through monthly auditor calls…

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