Billing and Coding Records AuditPECAAthe Professional Eye Care Associates of America, is thrilled to launch a new record audit service as part of the Billing & Coding program.

It’s no secret that Billing and Coding can be a complex and confusing process. However, what few doctors realize is how costly it can be as well.

Dr. Thomas Cheezum, who has gathered extensive experience working with practices to conduct billing and coding record audits, has found that most practices are under coding, and it is costing them an average of $30,000 per doctor in legitimate fees they are entitled to.

That’s why PECAA has teamed up with Dr. Cheezum to launch the Billing & Coding Records Audit Program – so that members can get a better understanding of how efficient their current billing is, and how they can maximize payments by improving their billing and coding procedures.

Here’s How It Works:

This program is exclusive for PECAA members, and will be offered at a reduced price of $575 per doctor.

In addition to this reduced price, if you wish to register for audits for additional doctors in your practice, those additional audits will be discounted even further at a rate of $525 per additional doctor.

For the audits, Dr. Cheezum will review 3 major things:

1.) Do the records meet the current record keeping/documentation criteria required by Medicare and other major medical carriers?
Dr. Cheezum will look at the record elements from the standpoint of how a “picky” auditor sent by a major medical carrier would evaluate them for compliance. This is to help assure you that if you are subjected to a formal audit, you can pass the audit.

2.) Do the codes billed support the billing of both the ICD-10 diagnosis codes and the CPT codes billed? Dr. Cheezum will review the current billing procedures to ensure the ICD-10 diagnosis codes are billed with the correct CPT codes. 

3.) Could another CPT procedure code have been used that would have resulted in higher reimbursement for the services provided?
After conducting several audits, we’ve found that most offices are under coding, and it is costing them an average of $30,000 per doctor in legitimate fees they are entitled to.

To perform the audit, the practices will be asked to send 15-20 exam records per doctor for patients seen for medical eye care. Among the records sent, we ask for 10-12 comprehensive exams for new and established patients, and the rest for patients seen for office visit services such as infections, foreign bodies, glaucoma progress checks etc. Dr. Cheezum will also want to look at some patients who have had ancillary testing such as visual fields, retinal photos and OCTs and to review the Interpretation and Report for those tests.

The audit will take ~1 week to complete.

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