Chart Audit for End of Episode Claims

What Each Screen Does

• End of Episode Claims Screen: Prints the selected episode audits
• Edit PPS Episodes Screen: Marks episodes as approved and ready for billing

Steps to Generate the Chart Audit Sheet(s)

• Go to Billing > PPS Billing > End of Episode Claims.
• Select Episodes: Use the right-bottom panel to choose episode(s) for the audit.
• Program and Payer: Enter the specific program and payer or leave blank to select all.
• Episodes Thru Date: Specify the date range for the episode(s).
• Select Episodes for Audit: Click this button to generate a list of patients matching your criteria. A list will appear in the first column. To remove any unwanted patients, click their name to exclude from the list.
• Print Chart Audits: Click this button to generate a chart audit sheet for each patient. Audits may span multiple pages depending on the episode length and data volume.

Report Options

• First Day of Audit Week: Set the start day for the calendar view.
• Print Calendars: Check to print a calendar view of each patient's episode with discipline abbreviations on visit dates. Leave unchecked to skip this.
• Mark Audit Printed: Check to mark the episode as printed in the Edit PPS Episode screen, updating the print date. Each print date replaces a previous date.
• Skip If Audit Previously Printed: Check to exclude previously printed audits, avoiding duplicates.

The audit sheet(s) will include the following:

• Orders: Discipline frequencies from Box 21 of the 485 and verbal orders. Ensure frequencies are in the correct format.
• Visits: Lists chargeable and non-chargeable visits by job code and date. Non-charge visits show an amount of $0.
• Calendar: If enabled, prints a calendar format with discipline abbreviations on visit dates. Non-charge visits follow a forward slash.
• Week-by-Week View: Shows the number of chargeable visits by each discipline per week, helping verify frequencies.
• Supplies: Lists Box 14 supplies and DME orders from the 485, plus any itemized supplies entered in Barnestorm.

Completing and Approving the Audit

After completing the audit and documentation:

• Mark as Approved: Go to Billing > PPS Billing > Edit PPS Episode: Select the patient and episode. Type in the employee code or name of the auditing employee. Click Mark as Audit Approved and Release for Billing button. This updates the audit approval date.
• Filter Claims: Use the Audit Must Be Complete option on the End of Episode Claims screen to select Only the episodes that have been approved for billing through the audit process.

Printing Status Reports

Print a report showing each episode's status from Billing > PPS Episode > End of Episode. Enter the program and payer or leave blank for all. Specify the Episodes Thru Date and click Print Audit Status Report. You can print in landscape or export to Excel. This report includes:

• Episode information
• Audit print date and age
• Audit approval date and age

Billing > PPS Episode > End of Episode

Billing > PPS Billing > Edit PPS Episodes