Millennium Healthcare Consulting, Inc

CODING AND DOCUMENTATION AUDITS

Millennium Healthcare Consulting, Inc’s ®, professional team of certified coding and compliance consultants perform independent coding reviews and education for physicians and staff, healthcare facilities, third party billing companies, CPA and law firms, and other healthcare organizations.

THE APPROACH:

Millennium Healthcare Consulting, Inc. ® conducts an initial phone interview with the client to determine their specific goals and objectives of the coding and documentation audit reviews.

MHC’s team of certified coding clinicians will then conduct an independent review of the documentation for the specific date(s) of services selected for review. The audit sample is customized based on the unique situation of its clients and in conjunction with the client’s internal compliance program or revenue enhancement initiatives. The audits are performed in compliance with AMA documentation guidelines and Medicare Correct Coding Bundling Edits. At times, MHC assists clients with certain payor documentation rules and regulations and collaborates with counsel to assist the client with potential misapplication of coding rules and regulations by third party payors.

MHC audits also retrofit nicely with the client’s existing or developing revenue ehancement programs. Audit results are clearly documented and regulatory sites are well documented. Many times audits are performed under the auspices of external legal counsel, thus providing a modicum of client privilege to results.

We assist our clients with two common types of audits:

External Standard Audit: Whether a part of client’s ongoing compliance program initiatives or revenue enhancement initatives-auditing, monitoring and post audit educational are the key components. Keeping pace with regulations and coding and billing changes is crucial to ensuring optimal reimbursement for all services rendered and be in compliance with federal and payor regulations. Our team of expert clinical auditors review the entire charge capture process to ensure compliance and capturing all appropriate services in your revenue stream. We communicate our findings in an Executive Summary Report Format in conjunction with a verbal on-site presentation to appropriate individuals so that all questions are answered, problems are understood and recommended pragmatic solutions are understood.

External Target Audit: At times, the client may have specific areas of concern based on a general internal audit, denials received or updates from Medicare or other third party payors. These types of audits are best conducted under the auspices of external legal counsel.

Millennium Healthcare Consulting, Inc’s ®, , is one of the independent review entity under settlement agreements between the plaintiff physicians and medical societies and several health plans. Under the settlement agreements, the health plans have established an independent review process for disputes with physicians over application of certain insurance company’s coding and payment methodologies. Details of the settlement are available at www.hmosettlements.com.