5 Auditors Come Clean About What Really Drives Them Crazy

Auditors love auditing. They just have a knack for it. A magical eye for detail, the ability to concentrate for long hours while they comb through medical charts. We've worked with so many auditors that tackle every job as if it were their last. But that doesn’t mean that sometimes they don’t want to rip out their hair. We reached out to some of our friends in the auditing community and asked them, honestly, what do they dislike about auditing or what drives them absolutely crazy.

1. “What I dislike the most is the lack of personal interaction. It can get lonely. And sometimes it’s difficult to read and stay focused all day, every day. I like to mix it up a little. Now, that being said, I find plenty of excuses to interact with people in my office.” -L. VonHagen

2. “What I dislike the most about the auditing process are the “grey” areas. Auditing can be a very subjective process and how one auditor interprets something may not necessarily be the same as another auditor. So these grey areas that are often left open to interpretation can be very frustrating for an auditor who likes to live in a black and white world.” -M. Johnson

3. “Most auditors that I know don’t like to audit illegible handwritten medical records, especially for services billed with higher levels. Having handwritten charts makes it difficult for the auditor to calculate the points but on the positive end sometimes the reviewer will notice things that the auditor didn’t and vice versa. Sometimes there are conflicts with handwritten notes.

Another thing I personally dislike is incomplete documentation within medical records. It delays the overall process of auditing. Whenever there is a missing record, we have to hold that lot until the missing information comes back. Then, we have to go through the client-specific guidelines once again and re-audit the complete chart. We might be working on another project when the missing information finally comes in so it can really burden the auditor.

Personally, I avoid auditing complex interventional cardiology because I don’t have experience in it. But I want to learn, so one thing I support is continuing auditor education.

Finally, sometimes I dislike is not using the right software. Using good software makes our job so much easier. The one I use doesn’t require me to open and save the ICD and CPT parts separately so we can work with CPT/ICD sections as one section, which saves a lot of time.”

- Anonymous

4.  Auditing things that drive me absolutely bonkers:

• Handwritten notes
• Long HPI notes that still lack 4 elements (seriously, WHY?)
• Assessments without plans and/or status of illnesses (i.e., stable, improving, worsening).
• Incorrect counseling and coordination of care time statements, or time statements without details of what was discussed/coordinated. -F. Brown

5. “Hmm, what drives me crazy? Dealing with providers when they absolutely do not want to listen because, according to them, you’re not clinical, so you can’t possibly understand their point of view, and they don’t appreciate “people like you” coming in to tell them how to practice medicine. Sigh. Just because my job is very technical doesn’t mean I’m a machine without emotions. Auditors are people, too.

I genuinely want to help you because 99% of providers aren’t taught to code, but it makes it hard to understand your frustration when you express it unprofessionally by essentially calling an auditor an idiot or going on a rant about how my profession and all that’s associated with it just sucks. Once I’ve talked them down (if that happens) they’re usually quite surprised to learn there is no one-size-fits-all approach to E/M coding, despite all the technicalities.

My other non-favorite thing is feeling like both a jack of all trades but an ace of none-not enough time in my day to become an expert on any one thing because there are 37 other things I REALLY need to bone up on.

And because I can’t be 100% negative, I feel like I have to throw a positive in there- my absolute FAVORITE part of my job is what I call “the light bulb moment.” That’s when you finally explain something just right to where the person you’re teaching “gets it.” I try to look for that relatable moment in every situation and use it as quickly as I can, then build up to progressively more complex topics that make SO much more sense now that the “easy stuff” makes sense.” -B. Sanchez