• Electronic Medical Records (EMR)
• Scheduler with Eligibility Test
• Compliance Management
  + Core Elements
  + Regulatory Risks
  + Auditing and Monitoring
  + Documentation Guidelines
  + Audit Exposure Evaluation
• Data Entry and Payment Posting
+ Charge Entry
• Superbill Interface
• Variety of Claim Entry Formats
• Fax
+ Demographic Data Entry

• Coding
  + Coding Consistency
  + Discovery of Undercoding
• Claim Submission to Payers
• Patient Invoicing
• Follow Up
  
+ Discovery of Underpayment

• Transparency, Analysis and Reporting
• Quality Control
  + Billing Process
  • Payment Distributions
  • Days in A/R
  + Claim Validation
  + Patient Eligibility Testing
  
• Data Center
  

• The payer audit establishes the percentage of under-documented (i.e., overpaid) claims
• Overpayment = (% of under-documented claims) x (Past 7 years)
• Audit likelihood is proportional to the difference of CPT frequencies between your practice and the national average

Affinity Billing provides audit process monitoring and control mechanism, which includes:
1. Automatic tests for notes presence prior to claim submission
2. Tracking for overcoding and audit exposure
   a. Automated identification of suspect claims
   b. Random manual internal audit

“Elimination of undercoding adds up to 3%-15% of total collections.”
Erstad, T., “Analyzing Computer-based Patient Records: A Review of Literature,” Journal of Healthcare Information Management, vol. 17, no. 4. 2003.