Has anyone developed an audit form for Revenue Integrity audits that is willing to share?
Hi, For whatever reason I am unable to attach a document, but I can describe our form. Each audit has an excel workbook. Each account is represented on a separate tab in a work book & we complete the following fields on each finding: Rev Code, Charge Code, Charge Description, HCPCS Code, Modifier, Service Date, Charge Amount, Undercharge Service Units, Undercharge Gross Revenue, Over Charge Service Units, Overcharge Gross revenue, Reason Type, Source Department of Charge, Free text reviewer notes. On each tab there are additional fields at the top where Demographic information is filled in including the Account Number, MRN, Admission/Discharge Date, Bill type, Primary payor, Facility name, Reviewer name, Charge audit ID, Review Date & Type of review. We have built in some drop downs for several of these fields to make filling in easier. There is also a summary report tab that brings much of the information from the individual tabs to summarize & tally up revenue impact and overall discrepancy rates.
I have also seen similar information be built into Access versus in an excel format. While the form we use serves its purpose, my organization is looking for a Revenue Integrity audit solution, but I've found that it's an area lacking in options. Most of the audit products out there are more about tracking external audits then they are about managing & trending your own internal audit findings