Decision matrix for audit appeals
Does anyone have any experience with creating metrics or even a checklist to help identify which audits are worth pursuing? We are receiving many more audits that we can possibly respond to under our current staffing, so it would be helpful to have a simple, straightforward (and unbiased) way to categorize which audits to prioritize. I feel like I have seen some aspect of this in audit software but have no personal or team experience with audit software.
We have a nurse auditor who is making these determinations on a case-by-case basis now, but we were hoping to be able to set up a decision matrix that might include factors such as % of claim being disputed, charge types, total dollar amount, etc. I thought I would ask here before starting in case anyone has done something similar and is willing to share.
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I am interested in this topic as well.