What action can an auditor suggest to assist a provider avoiding issues with a carrier?

An auditor can suggest implementing corrective action as a proactive measure to assist a provider in avoiding issues with a carrier. Corrective action typically involves identifying areas where compliance or performance issues may exist and developing strategies to address these concerns. This may include staff training, enhancing documentation practices, or improving internal processes for coding and billing.

By focusing on implementing corrective action, the provider can ensure that any compliance deficiencies are resolved, reducing the risk of audits, denials, and penalties from insurance carriers. This approach fosters a culture of continuous improvement and accountability within the practice, ultimately leading to better outcomes for both the provider and the patients they serve.

In contrast, while changing coding practices, revising the insurance contract, or reducing services offered may seem like viable options, they are not necessarily proactive steps directly aimed at preventing future issues with carriers. These actions may address specific concerns, but they do not inherently foster an environment of compliance and improvement that corrective action would encourage.