EE Audit Tool 2007-08

TML Intergovernmental Employee Benefits Pool20072008Revised October 2007Employee Audit ToolTABLE OF CONTENTSINTRODUCTION ...................................................................................................1STEP IHow Much Time Did the Service Take? ......................................................................... 1Commonly Identified Billing Errors ................................................................................ 2Unknown Provider Billing ............................................................................................. 2Bundling Procedure Codes ........................................................................................... 2Identifying Upcoding 2After Hours Charges .................................................................................................... 3Physician/Team Conferences and Care Plan Oversight .................................................... 3Preventive Medicine and “Evaluation & Management” Services ....................................... 3End Stage Renal Disease Services ................................................................................ 3Anesthesia Billings ...................................................................................................... 4Review of X-Rays Made Elsewhere ............................................................................... 4Special Reports .................................................................. ...