Some audit service providers utilize random or stratified random approaches to determine coding audit samples. Random audits are usually unstructured and address a broad range of coding and documentation practices. Accounts included in stratified random audits will address specific DRGs, coders, physicians, codes or service lines, and can sometimes provide insights into previously identified issues and targets.
Focused audits are highly structured with selected cases identified using data analytics that drill down into coded, financial and demographic data. Outcomes of focused coding audits identify those instances with the greatest opportunity for revenue integrity and performance improvement, ensuring maximum impact on current cases while helping identify training needs for coder development.
Thanks to our eValuator rules engine, Streamline Health performs highly focused audits that target the exact cases with the greatest opportunity for improvement.