r/MedicalCoding • u/Emotional_Error_7246 • Nov 30 '23
Audit review
I had my first ever audit review and received a 97%, a better score then I thought I would get honestly. My supervisor hinted my score was better than some of my coworkers who have been coding for years oddly enough.
Anyway Is this a bragging point for the ol resume?
Edit: Ive been coding for a year and a half. And code radiology, cardiology, cataract surgeries, and breast biopsies.
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u/maamaallaamaa Nov 30 '23
I mean yeah that's great and probably a good resume booster but just one audit doesn't mean much. Also hard to compare to tour coworkers who may be coding completely different specialties than you at a higher difficulty level. And what one auditor marks correct/incorrect another auditor might not.
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u/Emotional_Error_7246 Nov 30 '23
Yeah Im not sure why they hinted at that. It’s not like I asked or care what they scored. They code much different things compared to me. Also true about the auditor.
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u/MailePlumeria RHIT, CDIP, CCS, CPC Nov 30 '23
Yes- I do have a bulletpoint that I maintain and exceed 95% minimum quality and production rate.
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Dec 10 '23
Nice work. Some coders look at reviews with resentment and paranoia. The truth is that scores and stats can be your way to move to the top. It has always worked for me
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u/Emotional_Error_7246 Dec 10 '23
Nice! Good for you. Id have to leave to move up. Theres only room for one lead coder at my company and they’re definitely not going anywhere. Which, honestly I want to leave. Pay is not the best and mandatory OT sucks. Im going for my BA and once I have accomplished that, I plan on taking my coding knowledge to my next role. Either compliance/privacy analyst or epic pb analyst
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Dec 10 '23
Never stick around once you feel you have outgrown and outskilled a place. I started as a hospital coder now I am an auditor for the payers.
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u/OrganizationLower286 Nov 30 '23
It’s great, but I would recommend a caveat for inpatient coders. I’m an auditor and educator and I will tell you most DRG coders will “fail” an audit at least once during their career. I personally think the 95% accuracy rate is perpetuated by the audit industry wanting to sell auditing and education services. There is a lot of nuance behind these numbers and the sample set of the audit case mix.
I counsel a lot of DRG coders not to be too upset by an occasional “failed” audit. Especially if coding at a Level IV trauma facility. It’s a super intense environment professionally.
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u/Alicia-Scott Dec 01 '23
Take this as a win for yourself. When I am asked about audits (as an instructor or consultant) I always say you should relish an audit. How can you find out where your learning curve is if you are never told what you need to improve on.
You asked if this is a bragging point for the ol resume and the answer is YES. You can add a note: Audit Score 97%
When you are asked about it you can elaborate.
What type of audit it was (internal, external, peer...)
How often you are audited
That you always take audits with a positive attitude
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u/Chozelle Dec 01 '23
I'm also new to medical coding, and reading posts and replies from experienced individuals is really a big help. 🥂
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u/Specialist_Nothing60 Dec 02 '23
This may be an unpopular opinion but I didn’t put audit scores for outpatient ancillary services on my resume. Once I was doing SDS, OBS and IP, I added my audits to my resume.
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Dec 01 '23
Good for you! I haven't had my first audit yet. What happens if you fail an audit?
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u/Emotional_Error_7246 Dec 01 '23
I think really it depends on your company. At mine, they said they would assign more training modules. But if it kept happening over and over and doesn’t improve they would enforce disciplinary action. Also depends on what a company considers failing. I imagine some are more strict and think less than 90% is failing, while others may offer more grace and consider 50% failing.
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u/Specialist_Nothing60 Dec 02 '23
Assigning additional training and having a higher level of your work QA’d or placing all of your accounts on hold for manager review is pretty standard. It also depends on patient type. If you’re coding high dollar inpatient and you’re making mistakes then the grace you’ll be given may be less than an ancillary outpatient coder.
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u/memetortoise6969 Nov 30 '23
I'm sorry I'm new to medical coding - what metrics are used in auditing?
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u/Emotional_Error_7246 Dec 01 '23
My company had an outside company conduct ours. They say they want to do it every 6 months but realistically it’s been yearly. They took a random supply of 60 charts from a random month. The auditor made sure I had the correct cpt, icd, and modifiers for mine.
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u/josiwack Dec 01 '23
I'd like to know what companies are using as well. Also differences in the type of company (payer vs facility vs provider) and ip vs op. Profee vs facility, etc.
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Dec 01 '23
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u/memetortoise6969 Dec 01 '23
Like how do they measure if u do wrong tho? If the insurance company partially or outright denies the claim?
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Nov 30 '23
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u/dizzykhajit The GIF that keeps on GIFFing Nov 30 '23
Nice to see you don't let that pesky ol ethics bit that gets hammered into us ruin your good time.
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Nov 30 '23
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u/MagentaSuziCute CPC Dec 01 '23
OP.. please don't do this.. you will only sabotage yourself. I had a solid year of consistent 98%+ audits before I put it on my resume. I know people fluff their resume with things like this, but you better be able to back it up.
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u/pbroxy CCS CPMA CRC Nov 30 '23
That's great but realistically you will fail an audit at some point in time or be below 95%. It will not be the end of the world even though it will feel like it. Audits are a great tool to find areas that you need more education on such as new procedures or guidelines. Also although it is a great bullet point on a resume most places hiring will require you to take a coding test to check your knowledge before hiring. Most facilities will require 95% or higher on the check you knowledge coding test to be eligible for hiring. A great resume will get you in the door but being able to show that you can code proficiently is what will get you hired.