Do’s and Don’ts When Dealing with a Medical Record Audit

How to Present Your Case and Avoid Common Pitfalls

Medical record audits have become a significant source of stress for healthcare providers, including physicians, practice managers, billers and coders, and compliance officers. These audits, ranging from Medicare payment reviews to private payor evaluations and quality assessments, can be disruptive and opaque. Providers often find themselves at a disadvantage, unprepared to respond effectively, which can lead to denied or clawed-back payments. Without a clear understanding and strategy, navigating these audits can be frustrating and costly.

This webinar led by industry expert, Adam H. Laughton, provides healthcare providers with practical, actionable strategies to handle medical record audits efficiently and effectively. By adopting best practices, providers can reduce the disruption caused by audits, present their cases more persuasively, and ultimately achieve better outcomes. The session will cover essential do's and don'ts, equipping providers with the knowledge to avoid common pitfalls and strengthen their audit responses.

Why It's Important to Address:

As Medicare and private payors increasingly rely on audits to manage their expenditures, healthcare providers must be proactive in their approach. Failing to prepare or responding haphazardly can result in significant financial losses, strained resources, and potential reputational damage. By understanding how auditors think and what they look for, providers can position themselves for success, protecting both their practice and their patients.

Webinar Objectives

• Understand the Auditor's Perspective: Learn how to view your medical records through the eyes of a reviewer.
• Present Medical Records Effectively: Master the art of presenting medical records in a way that is clear, concise, and compelling.
• Avoid Common Pitfalls: Identify actions that can waste time, frustrate staff, or weaken your case with payors.

Webinar Agenda

• Overview of how audits and reviews are typically presented to healthcare providers.
• Exploration of 8-10 steps that can either help or hinder providers during an appeal.
• Finishing quiz to test understanding of key concepts.
• Q&A session to engage with the presenter and get answers to specific questions.

Webinar Highlights

• Why timeliness is a critical factor in helping providers win audits.
• The role of statistical extrapolation and how to effectively challenge it.
• The importance of contextualization and standardization in audit responses.
• How both overproduction and underproduction can harm a physician’s case.
• Insights into how auditors and reviewers think.

Who Should Attend

Physicians, practice managers, billers and coders, medical assistants, compliance officers