Selling your practice? Clean up the coding first.

Selling your practice? Clean up the coding first.
Physicians Practice Pearls – March 2019 
by Karen Zupko

As more and more practices are courted for acquisition, our firm is being engaged by both buyers and sellers to evaluate the accuracy of coding and documentation, and the efficiency of the revenue cycle.

The results of these audits indicate that in many practices, coding and billing has gone unsupervised and unmonitored for quite some time. If your practice is considering a sale, now is a good time to have an independent expert, qualified and experienced in your specialty, review your records and systems. If you don’t identify the coding issues, know that your potential buyer will.

Here are five issues that our auditors find with striking regularity.

1. Incorrect billing by non-physician providers (NPPs). 

In one practice we reviewed, the solo physician saw patients in the main office while the two physician assistants (PAs) saw patients in outlying offices. Yet, all NPP work was billed under the physician’s name. As a reminder, incident-to rules require that a physician be in the office when the NPP is seeing and billing patients “incident-to.” Otherwise, the care is billed under the NPP’s name.

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