Auditing is a key component to improving the financial well-being of healthcare providers and ensuring that they are current on their compliance requirements within different payer networks. This type of auditing includes conducting reviews of clinical documentation accuracy, compliance requirements and operational procedures to ensure providers are being as efficient as possible when treating their patients and supplying information to payer networks. Provider auditing yields a significantly different type of benefit than provider credentialing.
To ensure providers can administer the best patient care possible, stay within payment guidelines, and protect their bottom line, they must avoid incorrect or incomplete medical documentation. Despite a lot of these errors being unintentional, providers can easily fall victim to liability complications and legal ramifications due to documentation errors or compliance oversights.
Here are a few reasons to perform an audit:
- Geographical areas where there tends to be a high level of recorded compliance issues.
- Certain provider specialties that consistently need further review.
- Regulatory changes within a payer network to ensure compliance on new requirements and guidelines.
- Improve workflow and documentation practices.
Signature Performance Makes an Impact on Provider Auditing
Signature Performance understands the importance of provider auditing and the multitude of benefits that both providers and payers receive when an audit is successfully completed and implemented. Our team wants to make sure that physicians are not only qualified to provide high-quality care to those who need it, but we also want to ensure that their credentials are current so they can get paid in a timely manner for the care they provide. When credentials are not in order, the problem affects the provider’s bottom line and the overall patient experience.
Mitigating risk for payers and providers can have a profound effect on healthcare administrative costs. By creating action plans for providers, they can be sure that they are following the payer guidelines and federal regulations that have been established and eliminate unnecessary healthcare administrative costs related to denied or delayed claims.
We believe the healthcare system in the United States deserves only the best and that is what motivates our team to live our mission of reducing healthcare administrative costs for our clients. At Signature, our experience on both the payer and provider side of the business allows our dedicated team the opportunity to evaluate industry issues from a variety of perspectives, eliminate any static within communication efforts and create custom solutions that get to the core of some of the biggest problems facing the healthcare industry today.
To request more information about provider auditing, contact our team today!
Dawn Wierzbicki is the Senior Vice President of Partner Engagement at Signature Performance Inc., in Omaha NE. Signature Performance is an industry leader in reducing healthcare administration costs for private and public healthcare sectors. Our unmatched experience in serving both the payer and provider side of healthcare financial management allows us to implement innovative solutions for every administrative demand.