Blank Patient Charts - Excel - Excel by wbb39366

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									Using the charge-capture tool
1. Select a day to audit from at least three months ago.
2. Print a patient list from that day’s appointment schedule.
3. Pull the superbills for that day.
4. Print out the patient account detail for the date of service you’re auditing.
5. Pull the patient charts for that day.
6. Using the blank version of the audit tool shown on the second tab of this workbook, record the pertinent dat
7. Compare the diagnosis codes from the superbill, patient account and medical record and note any difference
8. If all or part of the claim was denied or if the amount of payment seems lower than the fee schedule amoun
9. Summarize discrepancies on a separate page, noting the dollar amounts of unbilled charges or others that s
10. Act on what you find.




Example:
                                                        Procedure   Procedures Procedures
                                          Procedure
               Provider      Date of                   codes from   documented provided
 Patient ID                              codes from
                initials     service                     patient     in medical  but not
                                           superbill
                                                         account       record     billed


     1           BAN        5/8/2008       99213          None       Office visit   99213


                                                                    New patient
                                                                                    99203
     2            JAL       5/8/2008      Not found       None      visit, quick
                                                                                     87880
                                                                     strep test
                                                                    Same, plus
                                           99396
                                                                      vaccine
     3           BAN        5/8/2008       82270         Same                       90471
                                                                    administrati
                                            90718
                                                                        on




                                           99214
     4           BAN        5/8/2008                     Same          Same          None
                                            17000




     5           DNA        5/8/2008       99214         Same          Same          None
                                                                    Same, plus
                                                                    wet mount       87210
     6           BAN        5/8/2008       99213         Same
                                                                     and KOH         87220
                                                                       prep
ok, record the pertinent data in each field.
ord and note any differences or discrepancies.
an the fee schedule amount, consult the explanation of benefits for more information.
ed charges or others that should have been paid.




              Allowed     Date and
                                                         Need
            charges for    amount            Lost
                                                      explanation      Notes
                 all       paid by         revenue
                                                      of benefits?
            procedures    insurance
                                                                       Charge
            $        85     None       $         85       No            never
                                                                       entered

                                                                        Lost
            $       128     None       $        128       No
                                                                      superbill

                                                                       Service
                           $143 on                                    provided
            $       168                $         25       No
                          5/28/2008                                    but not
                                                                        billed
                                                                         Two
                                                                      problems
                                                                     addressed,
                                                                         two
                           $125 on
            $       210                $         85       Yes        diagnoses.
                          5/24/2008
                                                                     No modifier
                                                                     25 on E/M.
                                                                        Never
                                                                     resubmitted
                                                                      Ineligible
            $       125     None       $        125       Yes
                                                                       provider
                                                                       Services
                           $57 on                                     provided
            $        85                $         28       No
                          5/24/2008                                    but not
                                                                        billed
                                                  Procedure   Procedures Procedures     Allowed     Date and
                                    Procedure                                                                                Need
             Provider    Date of                 codes from   documented provided     charges for    amount       Lost
Patient ID                         codes from                                                                             explanation    Notes
              initials   service                   patient     in medical  but not         all       paid by    revenue
                                     superbill                                                                            of benefits?
                                                   account       record     billed    procedures    insurance

								
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