August 1, 2016

ICD-10 Pre-Bill Auditing a Growing Area of Concern

Given the massive number of new ICD-10 codes and the Oct. 1, 2016 compliance date, HRS and ICD10monitor are producing a special-edition Internet broadcast that will focus on the imperative of pre-bill auditing.

The free broadcast will air live at 1:00 p.m. on Thursday, Aug. 4. The 60-minute live event is being sponsored by HRS. 

 “Given recent news about errors on documentation and coding audits, pre-billing should be a very high priority for providers,” said Chuck Buck, the broadcast’s executive producer and co-host of Talk Ten Tuesdays. “Pre-bill auditing can proactively target encounters, mitigating denial risk and preventing massive, repeated, and costly takebacks, while securing or improving reimbursement and providing insight about how claims should be billed the first time.”

Participating in the broadcast will be Kim Carr, director of clinical documentation at HRS, and Jonathan LaFleur, an auditor at HRS.

Buck said that Carr and LaFleur are expected to help providers identify examples of common and uncommon causes for inaccurately billed encounters. Buck also said that the upcoming special-edition broadcast would be particularly relevant for inpatient and outpatient coders, health information management (HIM) representatives, coding managers and educators, internal auditors, compliance specialists, and clinical documentation improvement specialists and managers. 

“Kim and Jon will also demonstrate how pre-bill auditing services can save an organization money and help avoid red flags that are raised by excessive rebilling,” Buck said.

Prior to joining HRS, Carr worked as a consultant implementing clinical documentation improvement (CDI) programs in various environments such as Level 1 trauma centers, small community hospitals, and levels in between. Before joining HRS LaFleur worked as a registered nurse in two emergency departments and as a charge nurse in the medical ICU at a Level 1 teaching hospital. During ICD-10 preparations, LaFleur performed audits for a national hospital network and then provided more focused auditing for a major university hospital.

“We are asking attendees to come prepared to have their questions answered during this live broadcast,” Buck said. “Both Kim and Jon are two nationally respected subject matter experts.”

Buck added that many healthcare industry experts are calling pre-bill audits the next ICD-10 hot-button issue.

Those interested in listening in to the special-edition broadcast can register here.
Mark Spivey

Mark Spivey is a national correspondent for who has been writing on numerous topics facing the nation’s healthcare system (and federal oversight of it) for five years. 

Related Stories

  • How 2018 Impacts ICD-10-CM Cardiology Diagnosis Coding
    There are now five types of myocardial infarction (MI) code categories, and the author describes these new options and how they will impact reimbursement. For cardiology, the focus of ICD-10 is generally on increased specificity and documenting the downstream effects…
  • How to Code the Flu in ICD-10
    Coding the flu consists of the signs and symptoms of flu, the vaccination, and coding the actual disease and its complications This winter has been a long one for those healthcare workers who have been busy treating flu patients and…
  • Three Key Initiatives for Improving Physician Education for CDI
    If physician training and education on clinical documentation is not done correctly, you might as well not do it at all It is common knowledge that the reason clinical documentation integrity (CDI) programs exist is to bridge the gap between…