This session was recorded on Friday, October 18, 2013.
Denial & Appeal: How Do Auditors See It All?
PLUS: Sharon Easterling’s 5-Ws for Documentation
This week we invited our good friend and sometimes auditor Bill Malm, ND, RN, CMAS of Craneware to help us understand more about how the auditors see our records and claims. The show also included Bill and Sharon going over a new strategy that Sharon has developed for satisfying documentation that auditors would easily understand.
The show was, to say the least, *lively* — many providers, physician advisors in particular, do NOT like what we had to say about how auditors look and records.
My message to you all: Don’t Kill The Messenger. WE are simply passing along what we KNOW to be true. Auditors do NOT spend much time reviewing the records before they decide to accept or deny a claim.
Why? Because they don’t have to. It’s not in their interest, it’s not in their contracts, it’s not what they are taught to do.
Is that fair? No. We agree, it’s NOT fair. But it is reality.
It was an EXCELLENT show, and you should listen to it.
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