Telehealth audit tool

February 2024

Since the onset of the Covid-19 pandemic, many health centers have scaled their telehealth services to better serve their patient populations. But many health centers are inaccurately capturing telehealth visits in patient charts or electronic medial records, leading to missing or rejected encounters and claims. This tool offers a comprehensive checklist that health centers can use to efficiently audit a random selection of 10 telehealth encounters.

Author

California Medical Association Physician Services Org (CMA-PSO)

Why use it

Community health centers need complete encounter data to demonstrate the quality of care they provide to their patient populations, including via telehealth services. This simple audit tool can support root-cause analysis and workflow process improvements that can positively impact the quality of the data being collected for reporting under NCQA HEDIS© and Uniform Data System (UDS) while also improving health center financials through better revenue capture.

Who it’s for

This encounter (chart) audit tool is suitable for roles that focus on root-cause analysis of issues with clinical documentation and coding, code mapping, and EHR templates at a community health center. Use this tool to support organizational collaboration and data sharing for process improvement.

Key take-aways

This encounter audit tool is designed to support a better understanding of how clinical documentation and coding supports encounter data (claims) and how root-cause analysis can be used to stratify common problems for process improvement:

  • Health centers are increasingly participating in value-based payments which require higher quality encounter data through cleaner claims.
  • Understanding how encounter data process improvement equates to better patient healthcare and more streamlined revenue are key concepts behind this audit tool.
  • Improved staff understanding of foundational concepts of Revenue Cycle Management (RCM), such as audit tools and root-cause analysis, will help create engagement and buy-in for workflow process improvement and change.

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IHA’s Resource Hub is made possible through a grant from Health Net, LLC’s Encounter Data Improvement Program.

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