Q&A: Additional documentation requests

Wednesday, November 15, 2017

Q: What is the best way to handle an additional documentation request for a pre-payment targeted probe and educate audit issue? 

A: Read the request to determine the issue being audited, review the records, be sure all documentation is authenticated, send the record. One common error is to not understand what they are auditing. If they are seeking medical necessity, you need to be sure the notes documenting the indications and previous treatment, if applicable, is in the chart. If it is drug administration, are the medication administration record and the RN notes present?

Note: This question can be found in the monitoring and audits category on the NAHRI Forums where you can find answers to questions on a variety of topics from billing and claims to compliance to reimbursement. This question was answered by Ronald Hirsch, MD, FACP, CHCQM, vice president of R1 RCM in the physician advisory services division in Chicago.