Coding and Auditing Services


IPMS comprehensive audits identify compliance risk in the following areas:

  • Coding

  • Billing practices

  • Documentation

IPMS Auditors are available to:

  • Conduct thorough audits to assure practice is accurate and compliant with government guidelines

  • Provide RAC or other Payer Audit assistance

  • Provide permanent coding support – be an extension of your staff

  • Provide temporary coding support for clients with employees away on medical leave or vacation

RAC Audit Support

Prevention: IPMS will perform a singular or regular post payment audit for your practice using industry standard auditing techniques and templates. This will identify areas of risk.

 

Defense: IPMS auditors can review your government audit with a view to defending your claims against documentation on file. Any audit by an insurance carrier can have serious repercussions and should be approached with due consideration.

 

IPMS Coding & Billing Audits cover such areas as:

  • Under or Over Coding or other billing risks

  • Correct modifier assignment

  • CMS billing rules

  • Under documentation

  • Time based coding

  • CMS surgical global periods

  • Incident To Rules

  • Shared Visit Rules

  • HIPAA

  • NCII Edits – appropriate application of bundling rules

  • Consults vs. Referrals

  • New vs. Established patients

  • 1995 vs. 1997 E&M Guidelines

  • Utilize CMS table of risk in assessing E&M

  • Audit E&M levels assigned appropriately – no up or down coding

  • Determine Bell curve for E&M

  • Place of Service accuracy

  • PQRI opportunities

  • Review Teaching physician guidelines when relevant

  • Check diagnoses for medical necessity

  • Assess PA billing practices

  • Review OIG Workplan for current year

IPMS Auditors are fully credentialed with the American Academy of Professional Coders.





Contact Us


Integrated Physicians Management Services
99 East River Drive
Fifth Floor
East Hartford, CT 06108

Phone: (860) 282-4124
Fax: (860) 282-0170
Email: contact@ipmscorp.com

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