Practice
  Management
  Consulting

  Billing
  Services

  Corporate
  Compliance
  Coding

  Client
  Case
  Studies

  Contact Us

Coding Audits

"It is advisable that bills and medical records be reviewed for compliance with applicable coding, billing and documentation requirements…a basic guide is five or more medical records per Federal payor (i.e., Medicare, Medicaid), or five to ten medical records per physician." (OIG Compliance Program for Individual and Small Group Physician Practices)

We provide two types of audits:

1. Claims audits that start with the collection of information on the superbill and end with the final resolution of the claim.
   
   
2. Coding and documentation audits, which assess whether the documentation in the medical record supports the level of service that was billed.

Educational Programs for Staff and Physicians

"Both initial and recurrent training in compliance is advisable, both with respect to the compliance program itself and applicable statutes and regulations. It is in the practice's best interest to ensure that individuals who are directly involved with billing, coding or other aspects of the Federal health care programs receive extensive education specific to that individual's responsibilities." (OIG Compliance Program for Individual and Small Group Physician Practices)

Education is a key component of any Corporate Compliance Program. We offer seminars geared to both staff and physicians on specific regulations and the components of corporate compliance. In addition, we offer intensive education on the proper techniques for Evaluation and Management coding.

Corporate Compliance Program Templates

"The creation of compliance program guidances is a major initiative of the OIG in its effort to engage the private health care community in preventing the submission of erroneous claims and in combating fraudulent conduct…. Physician Practice Management companies also may serve as a source of compliance program guidance." (OIG Compliance Program for Individual and Small Group Physician Practices)

The OIG recognizes that practices may need assistance in implementing a Compliance Program, and encourages physicians to look outside of the organization for assistance. Strategic Solutions can provide a template for a formal Corporate Compliance Program, with language and milestones that can be customized to the particular practice.