Guided Notes
Coding Audits & Provider Queries
How internal coding audits are run, sampling, scoring accuracy, writing compliant provider queries and educating providers.
Why audit?
Slide 1 / 6Coding audits compare the codes billed with what the documentation supports. They: • find errors before payers or government auditors do, • measure coder and provider accuracy, • identify education needs and process problems, • find overpayments to refund (within 60 days) and underpayments to rebill.
Audits can be prospective (before claims go out) or retrospective (after payment).