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Providing in-depth guidance for proper review of medical documentation in today's changing medical environment, this fourth edition of the Medical Record Auditor is full of new content. New topics include electronic health records (EHR), ICD-10 coding, Health Information Management and many other issues essential for maintaining compliance. Learn critical auditing fundamentals, read dozens of case studies, use the checkpoint exercises to test your knowledge, and download actual audit forms to help improve your process. Features and Benefits - New content addresses EHRs, ICD-10 coding and more - Downloadable forms. One copy of each audit form is included, but all forms are downloadable from website - Case studies. Ten different specialties are featured with more than 80 total case studies - Checkpoint exercises. Test your knowledge to confirm comprehension of new content
"This book helps readers understand the principles of medical record documentation and chart auditing. It introduces readers to principles of medical record documentation and how to conduct a medical record chart review in the physcian's or outpatient office"--Provided by publisher.
"Educates physicians, medical professionals, and support staff on proper medical record documentation, compliance, form handling, and medical record analysis for coding"--Provided by publisher.
The quality of coding is an important factor in determining the financial health of a practice. When problems occur they must be solved quickly. But before they can be solved, they must be found. Medical Record Chart Analyzer includes medical record documentation with a systematic guide to the medical record review process for the physician's or outpatient office. Learning objectives are included at the beginning of most chapters to overview chapter content and help measure progress. Medical chart review and coding tips are located throughout the book. The application exercises allow the reader to master each topic one chapter at a time. Also included is a final examination to test documentation and auditing skills. By the end of the book, the reader will be able to conduct reviews independently. Authored by Deborah J. Grider, CPC, CPC-H, CCS-P, CCP, an experienced professional in the fields of reimbursement, procedural and diagnostic coding, medical practice management and compliance. Readers can earn up to 10 CEU credits from AAPC.
"This book helps readers understand the principles of medical record documentation and chart auditing. It introduces readers to principles of medical record documentation and how to conduct a medical record chart review in the physcian's or outpatient office"--Provided by publisher.
An invaluable tool equipping healthcare professionals, auditors, and investigators to detect every kind of healthcare fraud According to private and public estimates, billions of dollars are lost per hour to healthcare waste, fraud, and abuse. A must-have reference for auditors, fraud investigators, and healthcare managers, Healthcare Fraud, Second Edition provides tips and techniques to help you spot—and prevent—the "red flags" of fraudulent activity within your organization. Eminently readable, it is your "go-to" resource, equipping you with the necessary skills to look for and deal with potential fraudulent situations. Includes new chapters on primary healthcare, secondary healthcare, information/data management and privacy, damages/risk management, and transparency Offers comprehensive guidance on auditing and fraud detection for healthcare providers and company healthcare plans Examines the necessary background that internal auditors should have when auditing healthcare activities Managing the risks in healthcare fraud requires an understanding of how the healthcare system works and where the key risk areas are. With health records now all being converted to electronic form, the key risk areas and audit process are changing. Read Healthcare Fraud, Second Edition and get the valuable guidance you need to help combat this critical problem.
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Electronic Health Records: An Audit and Internal Control Guide describes the infrastructure of electronic health records and the impact that the government's new criteria will have on the private and public marketplace. Understand what to look for in a health care record management system and find tips and helpful guidance for implementation. If you are trying to facilitate an audit of a health record management system, you can apply the example described in the model, which will serve as a timely model and invaluable resource.
According to the AAPC, a Certified Professional Medical Auditor has a good understanding of the knowledge of medical documentation, fraud, abuse, and penalties for documentation and coding violations based on governmental guidelines, and is well trained on medical record auditing skills. Of the various topics covered in the exam, Auditing, Documentation, Regulatory Standards and Statistical sampling are among those that are most difficult. This book focuses on these exam topics: Auditing, Documentation, Standards and Statistical sampling.
Clinical audit is at the heart of clinical governance. Provides the mechanisms for reviewing the quality of everyday care provided to patients with common conditions like asthma or diabetes. Builds on a long history of doctors, nurses and other healthcare professionals reviewing case notes and seeking ways to serve their patients better. Addresses the quality issues systematically and explicitly, providing reliable information. Can confirm the quality of clinical services and highlight the need for improvement. Provides clear statements of principle about clinical audit in the NHS.