Q&A: Responding to additional documentation requests for audits

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, and send the record. One common error is failing to understand what is being audited. If they are seeking documentation in support of medical necessity, you need to be sure the notes documenting the indications and previous treatment, if applicable, are in the chart. If it is drug administration, are the medication administration record and the RN’s notes present?

Note: This question can be found in the monitoring and audits section 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 at R1 Physician Advisory Services in Chicago.