AUDITING AND EDUCATIONAL PROGRAMS IMPROVE LARGE PHYSICIAN GROUP’S CODING ACCURACY CHALLENGE As a large physician group based in the Midwest added more physicians, group leaders realized there were no processes in place to audit coding on patient claims for compliance with guidelines from the Centers for Medicare & Medicaid Services (CMS). Furthermore, the group did not provide education on clinical coding and documentation to physicians and other clinicians. Consequently, about 40 percent of patient claims were either undercoded or overcoded. SOLUTION The physician group partnered with Navigant to provide its practices with annual claims compliance audits, special reviews of patient claims, and physician education on clinical documentation. After reviewing provider CMS claims,

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