The chart audit allows you to keep track of PPS episodes that have been audited and are ready for billing.  It gives you all of the episode information you will need to verify that visits match the frequencies ordered.  For this feature, you will be using the Billing > PPS Billing > End of Episode Claims screen and the Billing > PPS Billing > Edit PPS Episodes screen.  The End of Episode Claims screen will allow you to print selected episode audits.  The Edit PPS Episodes screen will allow you to mark each episode as approved (or complete) and ready for billing.

To start go to the Billing > PPS Billing > End of Episode Claims screen.  The right, bottom panel will allow you to select the episodes you want to print the audit for.  Even if the episode is on the EOE Error Report they will still show up on the audit list.  Enter the Program and Payer you want to use or leave blank to select all episodes.   Select the Episodes Thru date.     

Before you print the audit you have options to choose from:

First Day of Audit Week = This controls the calendar view.  Change the number to reflect the day of the week you consider to be day 1 of the week when writing weekly orders.

Print Calendars = Will print a calendar format of each patient’s episode, putting the disciplines abbreviation on the date the visit was done on.  If you leave this box unchecked it will not print.  See an example below.

Mark Audit Printed = If checked, this will mark the episode as printed in the Edit PPS Episode screen.  It will keep track of the date the audit was printed.  You can print the audit multiple times for a patient.  Each time you print it with this box checked, it will replace the printed date in the Edit PPS Episode screen (it does not keep track of each print date).

Skip If Audit Previously Printed = If checked, any audit that was printed before with the Mark Audit Printed will not show up on the report.  You can use this to avoid printing duplicate audit sheets.

Click on the Select Episodes for Audit button.  A list of patients that meet the criteria you entered will appear to the left.  If you do not want a patient on the audit list then click on their name to remove them.  Once the list and options look correct, click on the Print Chart Audits button.  A chart audit for each patient will generate.  Depending on the length of the episode and the amount of data, one patients audit could be more than one page.  The audit will include the following:

o   Orders = Discipline frequencies from box 21 of the 485 and verbal orders for the entire episode.  In order for this report to pick up the frequency it needs to be in proper format.   See the following link for troubleshooting:  http://kb.barnestorm.us/KnowledgebaseArticle50479.aspx

The following three examples are different ways to view when each visit was done.  Compare the number of chargeable visits for each discipline, for each week, to the frequencies listed above.   If a frequency is out of range, you may want to manually look at the verbal orders to make sure all of them showed up.  If a frequency is not in the correct format then it will not print on this audit.  Pull up the patient and go to Patient Info > Verbal Orders to search through each order.  You can go to Orders > Track Orders to pull up the verbal order and correct the format as needed (don’t forget to save it).

o   Visits = A list of charge/non charge visits order by job code and visit date.  This will tell you which week of the episode each visits falls in.  If the visit is non-charge, then the amount will appear as 0.00. 

o   Calendar = If you check the Calendar box before printing the chart audit, you will get a print out in calendar format of each patient’s episode, putting the disciplines abbreviation on the date the visit was done on.  Disciplines that follow a forward slash are non charge visits.   

o   Week-by-Week View = Shows the number of visits done by each discipline for each week of the episode.  Only the chargeable visits are tallied here.  This may be the easiest way to verify that frequencies are in order. 

o   Supplies = Box 14 Supplies and DME orders from the 485.  Also, an itemized list of supplies entered in Barnestorm.

Once the audit is complete and any necessary documentation is complete, you can mark the episode as approved and ready for billing.  Earlier we talked about the Mark Audit Printed option from the End of Episode Claims screen.  When you have this box checked and print the audit it will mark the Edit PPS Episode screen with the date it was printed (see example below).

To approve the episode as ready for billing, go to the Billing > PPS Billing > Edit PPS Episode screen and pull up the patient and episode.  Enter the employee who completed the audit and click on the Mark as Audit Approved, and release for billing button.  You will see the Date Audit Approved showing the current date. 

Once you start using this feature you can select the Audit Must Be Complete option (on the End of Episode Claims screen) when creating claims to ONLY select episodes that had the audit printed and marked as approved. 

You can print a report that shows the status of each episode from the  Billing > PPS Episode > End of Episode screen.  Enter Program and Payer or leave blank to select all.  Enter the Episode Thru date you want to use and click on the Print Audit Status Report button.  You have an option to print this report in landscape and/or export to Excel.  The report will give you the episode information, including the date the audit was printed, how long ago it was printed, the date the audit was approved, and how long ago it was approved.  This report only prints episodes that have a RAP created but not the EOE.

Billing > PPS Billing > End of Episode Claims

Billing > PPS Billing > Edit PPS Episodes