Audits & Reviews

 
 

 

Build Your Confidence with ACE audits & Reviews

ACE anesthesia compliance audits and reviews give you confidence that your processes and practices meet the requirements necessary to receive reimbursement for your services and avoid costly penalties and fines. 

Not sure which of our anesthesia compliance audit and review services is right for you? We offer options to meet your needs.

Start with our exclusive 360 ACE Audit of selected patient charts. We take a deep dive into the selected patient records and review the charts from initial consultation until claim adjudication. We’ll share our findings and provide an action plan that includes educating your team in any areas of concern.

Revenue Integrity Analytics (RIA) Audit is a new service made possible through HANK.ai.'s data mining techniques. Through the RIA process, we take an in-depth look at a year’s worth of claims, provide a detailed look at your RCM process and compliance, and generate a set of business metrics that highlight potential issues in your data set. A final report is provided that highlights potential discrepancies between electronic medical records (EMRs) and the billing data. RIA results should not be considered final or that noted discrepancies should be billed or would result in additional revenue.

Why do i need a revenue integrity analytics audit?

Need a custom audit?

Don't see what you need? Contact us to discuss a custom audit to meet your specific coding or compliance needs.

Our Approach to Audits and Reviews

Here is what you can expect should you choose to use ACE to audit your coding and compliance policies.

 
1

Evaluation of Needs & Proposals

Contact the ACE office to gain additional information about our services and to evaluate the “fit” between your needs and our offering. We will collect information regarding your expectations, group size, and case volume and prepare a proposal for your review. Click here to Contact the ACE office.
 
 
2

Retain Ace

Once you have accepted our proposal, a contract will be sent either directly to you or your legal counsel. If we are reviewing post-submission claims, we recommend that you engage our services through an attorney so comprehensive compliance reviews are performed under ‘Attorney-Client Privilege.’ It is the client’s choice whether to engage us through an attorney or independently.
 
 
3

Pre-Audit Conference Call with ACE Consultant

Prior to sending our audit preparation documents, we schedule a preliminary conference call between you and the assigned ACE Consultant. It is important for all of our clients to feel like they have a resource in ACE and have the opportunity to discuss the specifics of their situation prior to the ACE team beginning the audit.
 
 
4

Audit Preparation

We want you to receive the most value from ACE by utilizing our organizational tools to prepare for and understand the expectations of the audit. One month prior to your scheduled review, you will receive two documents from the ACE office:
1) A questionnaire that will need to be returned to ACE one week before the audit, and
2) A checklist to be used by billing staff and medical records in preparation for the first day of the audit.
 
 
5

records review

Time is spent reviewing records and educating key personnel. Education is the foundation of active compliance. At the end of every review, there are education sessions with providers, billing/coding staff, and administration to discuss findings and provide additional training. Annual education is a requirement for demonstrating active compliance. If you choose to utilize our operational review service, additional interviews and documentation will occur on-site as well.
 
 
6

Final Report

Within 10 days of the review completion you (or your legal counsel) will receive a written educational report that includes audit findings, education provided, action items, and detailed spreadsheets.
 
 
7

Your partner and resource

After the audit is done we don’t just disappear. For six months after your review, ACE is available to discuss your specific results as well as current issues within the specialty of anesthesia billing and compliance.