Download an overview of the WSMA's Chart Review Service.

Physicians and their practices are at tremendous personal and financial risk as audits by government contractors and health insurers threaten to recoup past payments. Refund requests in the thousands of dollars are not uncommon. Defending yourself and your practice against allegations of coding errors and inappropriate payments becomes very difficult for audited claims dating back two, five and even ten years.

The solution

Periodic expert review of your coding and documentation, as a component of your practice’s compliance program, to detect and correct errors, and ideally to prevent errors from occurring through ongoing monitoring and related education of physicians and staff.

The WSMA’s Chart Review Service can help you achieve those improvements in your coding and documentation activities.

How WSMA's Chart Review Service works

This service will provide your practice with a written report of our analysis of the coding and documentation of specific visit records and the services provided, drawn from selected charts as mutually agreed upon.

That analysis will review the accuracy of the codes—CPT and HCPCS service coding and ICD diagnostic coding—as selected by the practitioner, and the thoroughness of the chart documentation in support of those codes.

The report also will provide you with written recommendations for remedial actions where indicated. WSMA staff also will provide a post-review discussion, conducted via telephone, to address those findings.

As an optional service WSMA staff can provide your practice with additional training on code selection and coding documentation, offered electronically via web-based means or on-site.

Get started today in protecting yourself and your practice against allegations of inappropriate payments and costly refunds of payments received.

For more information, contact the Bob Perna, MBA, FACMPE, senior director, Practice Resource Center at (206) 441-9762, toll-free at (800) 552-0612, or rjp@wsma.org, or Michelle M. Lott, CPC, CPMA associate director, Practice Resource Center and health insurance coding specialist at (206) 441-9762, toll-free at (800) 552-0612 or mml@wsma.org.