Great, You’re a Perfectionist. Now What?
I’ve been auditing for almost thirty years. In that time, I’ve learned that auditors are typically extremely detail oriented, which is fantastic. But in order for that characteristic to be valuable, they have to learn how to come out of the weeds and look at the documentation they routinely evaluate without judgment. Part of what makes us good auditors, can also create challenges when it’s time to deliver audit results. The goal is to change behavior but that’s not easy to do if we judgmentally attack physicians. Sometimes we’re so focused on the code and the details that we aren’t able to see the big picture.
Not Audited, Not Done (Not True!)
From a technical perspective, most of the time when we have to change an audited code, it isn’t because the service didn’t happen. The patient probably got what the physician billed but sometimes the details or the work that the physician did in their head doesn’t get communicated in the medical record in a way that can be counted towards that service. For example, if my doc gives me an antibiotic shot, if they don’t write it down in a way that credit can be given for it then it becomes a non-billable finding. One of those adages that has been around since I’ve been doing this, that drives me insane is, “not audited, not done,” but that isn’t true. Not getting credited for something doesn’t mean they didn’t do it. Just because a physician didn’t write it down doesn’t mean I didn’t get the treatment.
Medicine Isn’t About Coding
At the end of the day, medicine isn’t about coding, it’s about patient care. Our goal as auditors is to provide information that assists providers in capturing the medical details. This is the only industry where the person billing, the doctor, is required to meet three distinctly different jobs and for only one patient. They have to meet criteria for patient care, billing/coding, and legal. And sometimes the messages for those different needs are all different from each other. So when we’re auditing, we need to take all of this into consideration to prevent our perfectionist brains from getting the best of us, thus creating frustrated, judgemental, monsters.
Download this free eBrief, What Auditors Should Always Remember (And 3 Things You Should Never Do), for advice on how to approach auditing with a different perspective that will make you more effective in your day-to-day. In this eBrief, you’ll learn how to be weary of perfection, communicate effectively to effect change, and stay grounded and connect with physicians.