Here’s an Example of a Written Process
Billing Review Process
R. Smith, Registration Number: XXXXX
1. On the first day of each month, I will obtain a record of all of the previous month’s billing done using my name and registration number.
I will audit this billing record by randomly selecting 20% of invoices for each funding stream. I will also obtain clinical records for each patient selected for the audit as they contain the dates and descriptions of each patient encounter and can be used to cross-reference billing records. I will determine if:
a) Services billed for were actually provided by R. Smith, PT.
b) Services billed for were actually physiotherapy services.
c) Fees were not charged for any services that have already been paid in full.
d) Services billed for were not excessive. I will compare the billing record to the fee schedule for assessments, treatments and re-assessments for each funding stream.
e) All services provided were billed for (e.g. none are missing from the billing record when checking all billings)
I will check all billings for the month if more than 10% of billings reviewed contain inaccuracies. For the first month at any new job, I will check all billings.
After the above review, I will sign off on the audited billing record and retain it to demonstrate that a review was done each month.
If any inaccuracies are discovered I will take the following steps:
a) Contact payers and cancel or correct any incorrect invoices
b) Document the inaccurate findings and action taken along with the outcomes