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Patient Name: Date of Service: Provider: Medical Record #: E×M Audit Form 1995 HISTORY Chief Complaint: History of Present Illness (HP): Brief (13 or update 12 Chronic) Extended (4+ or update of
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How to fill out em audit form

How to fill out an EM audit form:
01
Start by carefully reviewing the instructions provided with the EM audit form. Familiarize yourself with the purpose of the form and the specific criteria that need to be evaluated.
02
Ensure that you have all the necessary information and documentation required to accurately complete the EM audit form. This may include patient records, billing information, and any relevant medical documentation.
03
Begin filling out the form by providing the requested demographic information, such as the patient's name, date of birth, and contact details. It's important to double-check the accuracy of this information to avoid any potential errors.
04
Proceed to the main section of the EM audit form, where you will record specific details about the medical services provided. This may include the date of service, the type of procedure or treatment performed, and any associated diagnoses.
05
Carefully assess each criterion provided on the form and rate the performance according to the given guidelines. Use the provided scale or scoring system to indicate the level of compliance or non-compliance.
06
Provide any additional details or comments as required by the form. This could include any notable observations, complications, or recommendations for improvement.
07
Once you have completed all the necessary sections of the form, review it for accuracy and completeness. Make any necessary revisions or additions before submitting it.
08
Keep a copy of the completed EM audit form for your records, and submit the original to the appropriate entity or organization responsible for collecting and reviewing these forms.
Who needs an EM audit form?
01
Medical professionals: EM audit forms are typically designed for medical professionals, such as physicians, nurses, and healthcare practitioners. They use these forms to evaluate the quality and accuracy of their own medical documentation and billing practices.
02
Medical coding and billing departments: EM audit forms are often utilized by coding and billing departments within healthcare organizations. These departments review the completed forms to ensure compliance with coding standards, documentation guidelines, and regulatory requirements.
03
Healthcare organizations: EM audit forms may also be required or recommended by healthcare organizations, such as hospitals or clinics, to monitor and improve the quality of care provided by their staff. These forms help identify areas of improvement and ensure the accuracy of medical documentation and billing practices.
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