Insurance audits are a reality for therapy clinic owners. Getting audited can be one of the most stressful things to happen to you as a business owner. After all, if you don’t pass an audit, it could mean returning large sums of money to the insurance company.
So, what will you need to guarantee compliance? That can vary. Some audits cover your entire practice, while others are specific to a few patients or providers. Here are a few examples of documents you could be expected to provide:
- Financial records
- Daily progress notes
- Evaluations
- Plans of care
- Billing logs
- Appointment calendars
- Provider documentation
In short, the more detailed history you keep, the better. Be ready to produce any records that pertain to your practice at any moment. But don’t panic! There are a few things you can do to prepare and, in turn, ease your worries about an insurance audit.
First, keep your admin team organized. It is of utmost importance that you and your administrative staff know where to find everything in the event of an audit. This way, you can easily identify if any records are missing or incomplete right away, rather than spending the days allotted trying to locate the pertinent files. This is especially important if your clinic uses paper records. Get those filing cabinets in order!
It’s also wise to spend the extra time it takes to set your therapists up for success. This may mean training them on a better way to complete notes or hiring extra admin help to answer their questions and keep an eye out for holes in the system. Review your billing logs in detail to identify areas in which your team of providers could improve.
By far the best way to be ready for the dreaded audit is to use electronic medical records (EMR) software. However, just having an EMR is not enough. It should be an EMR that will house everything you need when an audit notice arrives. This way, you’re not referring to the EMR for some details and searching around for others.
Unlike generic EMRs, TheraPlan has your back during an audit. Using our 25 years of experience consulting with and billing for therapy clinics of all sizes, we designed TheraPlan according to the audit requirements of Florida Medicaid, Medicare, and Early Steps. If your therapists completely fill out our audit-guided documentation, you’ll have less reason to worry!
Want to know more?
Read about our audit-guided note templates and other features of our efficient documentation system.
