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Are We Actually Fine? | Coding Advantage, LLC
Coding Advantage, LLC

Are We Actually Fine?

Behavioral Health Leadership Compliance Reality Check

This quick assessment is built for executive and operational leaders in behavioral health and healthcare organizations. It focuses on oversight systems, not clinical detail.

If leadership cannot confidently answer these twelve questions, there may be hidden compliance exposure waiting to surface during the next audit.

Answer honestly. Your score stays on this page. Nothing is transmitted unless you request the follow-up report at the end.

Documentation Oversight
01.Do we have a clearly defined clinical documentation review policy that goes beyond peer supervision or clinical sign-off?
02.Are documentation reviews performed from a billing and compliance perspective, not just a clinical quality perspective?
03.Do we routinely review whether the services documented in the record actually support the services being billed?
Billing Pattern Monitoring
04.Do we run internal reports that monitor patterns of billing that insurers commonly target for review?
05.Does leadership regularly review data on coding patterns, utilization trends, and outliers compared to peers or historical performance?
06.Do we understand which services in our organization represent the highest audit risk based on payer focus or reimbursement level?
Audit Readiness
07.Does our organization conduct internal audits before a payer or regulator requests records?
08.Do we have a defined process for addressing documentation or billing issues when patterns are identified?
EMR and Template Integrity
09.Does leadership understand the capabilities and limitations of our electronic medical record system?
10.Are there known EMR workarounds or template behaviors that could create documentation risk?
11.Do our templates support individualized documentation rather than cloned or copy-forward notes?
The Honest Question
12.If a payer requested 100 records tomorrow, are we confident the documentation would clearly support the claims submitted?

Get Your Personalized Risk Report

Enter your details to unlock your score, a breakdown of your flagged areas, and a follow-up resource packet from Coding Advantage.

Risk Level
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Want a Professional Review?

Coding Advantage helps behavioral health organizations turn audit anxiety into documented defensibility. If any of the areas above concern you, let's talk before a payer does.

www.codingadvantage.com
Coding Advantage, LLC | Behavioral Health Billing and Compliance Consulting
Sonda Kunzi, CPC, COC, CPMA, CRC, CPB, CPCO, CPPM, CPC-I