6 Tips For a Winning Post-Audit Strategy

One of the most important audit tasks is delivering the post-audit results. Our goal as auditors, is to give feedback in a way that leads to improvements in accuracy and documentation. Delivering the post-audit interview is a delicate task. Walking in with a critical attitude and listing off a bunch of errors, will have the opposite impact you’re going for. Instead of effecting change, you’ll just create a defensive environment that leads to nowhere constructive.

The following is a list of tips to make your post-audit work a positive and productive experience. These tips will not only make the post-audit interview go smoothly but they’ll also help you get real results.

This is just the tip of the iceberg. Post-audit interviews are complicated and they need to be executed just so for effecting change.
Download our free Shortlist, "How to Conduct an Effective Post-Audit Interview," for the full list of tips for a post-audit interview that gets results:

First, Consider Your Attitude and Approach

1. Begin with the end in mind. Never allow an emotional response to the complexities of the coding or perceived administrative hurdles deter you from targeting the desired change (i.e., different coding or strengthened documentation).
2. Set the stage. The goal is to help them close any documentation gaps, obtain accurate reimbursement for their services and protect revenue.
3. Be respectful. Your audience deserves your respect. Respect and patience are essential to developing a relationship that will allow you to effectively communicate important information. If necessary, allow the provider to vent any frustrations with the system, the EMR, the coding structure. You can use these frustrations to segue into a teaching moment and direct the conversation towards solutions. Arguing won't help anyone achieve their goals.

Second, Be Prepared With Useful Information and Potential Solutions

1. Review the findings. The auditor providing this post-audit work must know the issues that caused any variances. Your provider will quickly lose interest if you simply read the report to them. Before the meeting, think about the issues and potential solutions. Discussing issues in order of risk is a valuable tool. Beginning with compliance risk (over-coding); moving to revenue risk (under-coding) and closing with diagnosis code variances proves to be an effective way to keep the provider’s attention.
2. Plan to Keep it simple. Don’t complicate the issue(s). Identify the key element(s) that supported the billed code as well as those that caused a variance. For example, you might note that the complexity of MDM matched the billed EM levels but the documentation of the history element did not include a family history.
3. Organize the findings. Build a “sandwich”.
   • Tell them what you want to talk about (EM, CPT, HCPCS II and/or ICD as appropriate).
   • Explain (by topic) the cause of variances.
   • Suggest solutions as appropriate.
   • Summarize any actions to power the solutions.