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Proactive Audits for
Risk + Revenue

The 3 R’s
RISK, REGULATIONS, AND REVENUE

As an E+A coding client, our team also monitors your revenue and compliance environment for adherence to industry rules and regulations. We provide detailed reporting and recommendations on downcoding, documentation education, risk identification and opportunities for improvement. Our compliance activities are based on the Seven Fundamental Elements of an Effective Compliance Program. This includes:

  1. Implementing written policies, procedures and standards of conduct.
  2. Designating a compliance officer and compliance committee.
  3. Conducting effective training and education.
  4. Developing effective lines of communication.
  5. Conducting internal monitoring and auditing.
  6. Enforcing standards through well-publicized disciplinary guidelines.
  7. Responding promptly to detected offenses and undertaking corrective action.

WHY CHOOSE AN E+A AUDIT?

Our proactive audit service ensures that your organization remains complaint amidst continually shifting regulations. Without our detailed review of your practice, billing from incomplete documentation and/or our impact studies when coding and/or payment regulations change, your revenue can take an unplanned hit. For clients who are engaged in managing revenue cycle processes, regulatory changes require modification of policies, procedures, checks and balances and Edelberg + Associates is here to assure all goes as smoothly as possible.

AN E+A COMPLIANCE AUDIT/EVALUATION INCLUDES:

  • A line-by-line analysis of all codes from a chosen sample of records
  • A comparison of your submitted codes and charges with those supplies by an E+A auditor
  • A formal report documenting total lost charges, a percentage of non-compliance codes, an error and accuracy rating and
  • An executive summary with recommendations for remedies and regulatory support for recommendations
  • An in-person review or conference call to discuss findings is available on request

LEARNING FROM YOUR E+A AUDIT

If your audit/coding review indicates opportunities for improvement, our E+A auditors and executive team will provide consultation services at your request. We offer onsite or online consultations customized to the needs of your organization or practice. Documentation advice, coding input for providers who do their own coding and training for specialty coders are services we can provide on a consultative basis. And if education is what you need, our on-line, self-study program is something to behold! Developed by physicians, nurses, coders and auditors, our on-line training will improve documentation and coding immediately and produce detailed training times, success rates and strengths and weaknesses of participants to responsible parties or individual practitioners and coders on demand.

See Our Coding

CLIENTS WE SERVE

  • Urgent Care
  • Primary Care
  • Emergency Departments
    • Professional
    • Facility
  • Hospitals and Hospital Systems
  • Hospitalists
  • Ambulance and EMS
  • Multispecialty Clinics and Practice Groups
  • Legal Representation
  • Teaching Hospitals