Provider Audits

Our audit program is in place to monitor compliance with applicable laws and UBMD policies. The focus of the program is to assess the accuracy of documentation and coding of UBMD providers, while the objectives are:

  • To ensure accurate, complete and legible documentation of medical services provided;
  • To ensure proper coding and billing based on the documentation;
  • To determine whether or not any problem areas exist in documentation, coding or billing, and if so, to focus on improving those areas with the physician.

Routine prospective chart review (Periodic Audit) is required for each Practice Plan to assess compliance with the established standards of practice and billing guidelines.  Charts will be audited without regard to payer type. 

There are several types of audits that may be performed, including: