Clinician’s Guide to Audits: Know the Triggers, Manage the Risks, Stay Ahead

Only available as part of a package

Session Summary: This interactive session provides practitioners with real-world insights into how documentation impacts coding accuracy, billing compliance, and audit exposure. Using post-acute and long-term care (PALTC) examples, wea??ll explore what auditors look for, how patterns trigger reviews, and why well-intended notes may fail standards. Learners will engage with national/local coverage guidelines (NCD/LCD), audit and appeals processes, and understand why quality (not quantity) matters. Through case-based learning and interactive polling, this session empowers primary care providers to document confidently, support accurate coding, and enhance compliance, reimbursement, and clinical outcomes. By building audit literacy and documentation skills, healthcare professionals strengthen their roles as clinical leaders, supporting revenue integrity, educating peers, and reducing risk in the PALTC setting.

Learning Objectives:

  • Describe the audit process from initiation to completion, including how providers/practices are selected, common PALTC audit triggers, and key elements auditors review in documentation.
  • Apply proactive strategies to reduce audit risk, such as pre-audit reviews, coding to medical necessity using NCD/LCD guidance, and identifying high-risk patterns.
  • Outline post-audit appeals and recoupment processes (e.g., CERT, RAC) and begin developing an action plan to strengthen audit readiness and compliance in their practice or organization.

Michelle Martin, CPC, CPB, CPMA

Director of Documentation Integrity

Eventus WholeHealth

Michelle Martin, CPC, CPB, CPMA, has over 20 years of experience providing education and training across diverse healthcare settings, including clinician education sessions, leadership briefings, and committee meetings. Her expertise spans healthcare compliance, clinical documentation, medical auditing, and coding integrity, with a focus on post-acute, long-term care, assisted living, and home-based care. She has led both virtual and in-person sessions, ranging from small-group workshops to presentations for over 200 attendees. She collaborates closely with clinicians, coders, and auditors to deliver practical, engaging, and compliance-aligned content tailored to each audience’s needs.

Jamie Smith, FNP-C, CPMA

Jamie Smith, FNP-C, CPMA, is a Clinician Training Specialist for Eventus Wholehealth. She has served as an educator and nurse practitioner for a total of eleven years. Her passion for educating extends beyond just to those in the organization. She is an advocate for education to all those involved in the care of patients. She has served as an author of Geriatric Notes alongside Dr. Brad Goad with Premier Geriatric Solutions (now a part of Eventus WholeHealth), and served at PGS in the capacity of Chief Education Officer.

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