Generic Billing Audit Check List

HBP Billing Audit Check ListFocus Task DetailEstablish the relationship between Department volumes and Charges Charge Verification Billing System volume. Calculate gross charges and compare with accrued month of service results. Use a three month delayEvaluate Department Accession Control Logs to determine if all services have been accounted for and billed. Obtain the Charges Charge Controlhospital revenue reports to compare professional counts with the volume of technical services. If the charges come from electronic downloads, verify reports from each of the modalities to compare with the data entered Charges Electronic Chargesinto the billing system. Obtain a complete Accession report as well as the missings list.Perform an independent review by a Certified Coder of CPT and Charges Coding ReviewICD-9 usage. Identify date relationships - Date of service, Date of reading, Charges Process Flow Date entered into the system and Date actually billed. Flow Chart?Are modifiers being used appropriately for billing to reduce Coding Use of Billing Modifiersclaim rejections? How are these rejections handled?Is each service reviewed by a certified coder before it is entered Data Entry Coding into the system? When errors are discovered how are they CodingReview reviewed with the Physician and approved? Is a log maintained and results quantified on a monthly basis?Are physicians using the appropriate reporting codes (ICD-9, CPT Category I and ...