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Author Question: What is the difference between a prospective and a retrospective audit? What will be an ideal ... (Read 118 times)

rayancarla1

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on: Jun 27, 2018
What is the difference between a prospective and a retrospective audit?
 
  What will be an ideal response?

Question 2

When documentation does NOT support the level of service provided, and a lower-level code should have been selected, this practice is known as__________ .
 
  Fill in the blank with correct word.
Comprehensive Health Insurance: Billing, Coding, and Reimbursement ¦ Vines, Braceland, Rollins, Miller ¦ 3rd Edition
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Jossy

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Reply #1 on: Jun 27, 2018
Answer to Question 1

Answer: A prospective audit is done before a claim is submitted; a retrospective audit is completed after reimbursement is received.

Answer to Question 2

upcoding


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