As more physicians begin relying on electronic health records (EHRs) to help them document office visits, the government is doubling down on E/M audits to counter growth in “cloned notes,” which are visits documented in identical or near-identical terms, by EHR systems.

A year ago, the Obama administration sent a warning to major hospitals and healthcare organizations about suspicions that some of them were deliberately committing fraud by upcoding E/M services, using the tendency of EHR systems to generate similar notes as cover.

The government has done more than issue threats; the OIG is increasing the amount of E/M audits while CMS has gotten its recovery audit contractors (RACs) involved in E/M audits. Software used to detect plagiarized documents, such as student-authored papers in the academic setting, are being employed to crack down on E/M documentation.

Earlier this year, HHS proudly announced that the government earns $8 for every $1 it spends performing audits – a recovery ratio that means brisk business for the government and its contractors, and major risk for providers.

Provider response: The best practice to follow in these uncertain times is to figure out whether your physicians are at risk by benchmarking their E/M patterns. You can do this with leading audit software such as E/M ProCheck, which also performs chart audits quickly, averaging six minutes per individual chart.

Free CEUs: Learn more about E/M ProCheck and the latest trends in government auditing by attending our free webinar on Tuesday, Sept. 10. You’ll earn 1.0 CEUs from the AAPC for free, just by listening. In addition to the AAPC’s standard CPC certification, your free credit is also good for AAPC’s specialty certifications, including:

  • Evaluation and Management (CEMC™)

  • Certified Professional Medical Auditor (CPMA™)

  • Physician Practice Manager (CPPM™)