Physician Billing Best Practice: Prepare for Meaningful Use Audits

July 17, 2014 by Antonio Arias, MBA, CHBME

Topics: Medical Billing, Revenue Cycle Management

NCG Medical is more than an Orlando medical billing company, we also develop practice management software, document management software and electronic medical records (EMR) to aid all aspects of revenue cycle management. Lately we have been hearing more and more from EMR users about government Meaningful Use (MU) audits.

As a physician billing best practice, we recommend you complete an internal review of your reporting measures to ensure you can defend any challenges in a formal audit.  We also recommend keeping all of your supporting documentation together for each attestation year.  

As part of your effective revenue cycle management, every eligible provider (EP) in receipt of EMR incentive money should be prepared for a Meaningful Use audit. During an MU audit each measure is scrutinized and if an EP is out of compliance with any of the MU measures, or fails to provide supporting documentation, all of the EMR incentive money received by the EP is rescinded. However, being prepared is easy. CMS provides materials documenting what auditors will require for each MU measure.  You can find the materials here.

Here is a quick summary of the documentation you will need:

% based threshold measures – Report generated from the EMR software needs to include:

  1. Evidence of the reporting for the EP being audited
  2. Evidence on the report that it was generated from the purchased EMR software
  3. Time stamp for the reporting period
  4. Numerators and denominators

Non % based measures - Requires a yes/no response and needs to include:

  1. Clinical Decision Support Rule – Screenshots of a CDS from the certified EMR dated during the reporting period
  2. Protect Health Information – A report dated prior to the end of the reporting period that includes the procedures performed and the results.
  3. Generate list of patients – A report with a specific condition from the certified EMR dated during the reporting period
  4. Registry Data Submission –
    • Successful – Screenshot of submission dated during the reporting period
    • Exclusion – Letter or email from registry that states EP was unable to submit.
  5. Exclusions – Report from certified EMR that shows the zero denominator

Conducting an internal review should be a high priority for any EP that has received incentive funds. This best practice ensures that your will be prepared should you receive an audit notification in the mail. 

Are you interested in improving your medical billing process? CLICK HERE! 

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