Coding Audits & Provider Queries

Coding 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).