M1 provides a variety of audits for both Federal and Commercial Entities.

Including: Clinics, Physician office hospital and nursing home visits (including specialties such as cardiology neurology and interventional radiology). As part of a facilities Compliance Program, it is recommended to have an external coding audit (Inpatient, outpatient or both) at least annually to gauge if the current coding accuracy rate meets a 95% standard. If below a 95% accuracy rate M1 recommends additional education and more frequent audits to assist the facility in achieving compliance as instructed by the OIG.

A facility who commits to providing a robust external audit ensures a reduction in coding errors, minimization of billing mistakes and reduces the chance a CMS based audit will be conducted.  Our audit is based on the volume of claims billed annually and will dictate the amount of records to be reviewed.

M1 can assist you with selection of records and volume to be reviewed. Often our clients opt for monthly and quarterly review to check a coding pulse on accuracy throughout the year. This is a best practice and has many benefits for not only the facility but to the coding staff.

After the audit is completed, M1 will make available to the provider a high-level written summary for administration, a detailed description for the Health Information Department, and an overall accuracy rate for the facility. In addition, M1 provides education for coders who were part of the audit and feedback is given to enhance coding skills and improve future accuracy. CEU’s are also earned for each coder participating in the education.