La. Admin. Code tit. 37 § XIII-2511

Current through Register Vol. 50, No. 6, June 20, 2024

Section XIII-2511 - Provider Audit Coordinators

A. Providers shall designate an individual to coordinate all billing audit activities. An audit coordinator shall have the same qualifications as an auditor (see §2507, Qualifications of Auditors and Audit Coordinators). Duties of an audit coordinator include, but are not limited to, the coordination of the following areas:

1. scheduling an audit;

2. advising other provider personnel/departments of a pending audit;

3. ensure that the condition of admission is part of the medical record;

4. verifying that the auditor is an authorized representative of the payer;

5. gathering the necessary documents for the audit;

6. coordinating auditor requests for information, space in which to conduct an audit, and access to records and provider personnel;

7. orienting auditors to hospital audit procedures, record documentation conventions, and billing practices;

8. acting as a liaison between the auditor and other hospital personnel;

9. conducting an exit interview with the auditor to answer questions and review audit findings;

10. reviewing the auditor's final written report and following up on any charges still in dispute;

11. arranging for payment as applicable; and

12. arranging for any required adjustment to bills or refunds.

La. Admin. Code tit. 37, § XIII-2511

Promulgated by the Department of Insurance, Office of the Commissioner, LR 20:311 (March 1994).

AUTHORITY NOTE: Promulgated in accordance with Act 664 of the 1993 Regular Legislative Session and R.S. 22:12.