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Internal Auditing
One of every provider’s biggest fear, no matter the specialty, is going through audits from Medicaid or commercial insurances. With Enlightened Solutions, you have access to an Audit Specialist to review and analyze your treatment plans, progress notes, and other processes to verify that all records meet Medicaid compliance requirements and standards. We keep track of constantly changing requirements for Medicaid, the state(s) you are licensed in and all federal requirements. Our Auditing Specialist can verify CPT codes/diagnosis codes being used are appropriate and provide clinical support with expressing what modalities are used and how to build a proper progress note from a clinical standpoint.
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Audit reporting can be conducted weekly, monthly, quarterly, or yearly. We will work with you and your providers to make sure that your medical records are compliant so you will feel confident and secure when the audit season commences. If your records will pass a Medicaid audit, then they will pass audits for all insurances. This role is offered on a full and part time basis, tailored to your practice needs.
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