expectations would be approximately two to three services per visit though there are times for four. Four would be at a high level and the tendency would be a provider who bills four services per visit more likely would have a review. Again, the review doesn't mean you've done wrong, but we have to show justification of why we've done so many services. The other fact would be just simply length of care. Your length of care certainly will also set you up for audit. If you treat patients much longer than other providers they're certainly going to look and go, “Why is this provider treating much longer than others,” hence, a review or an audit. The other factor that will come in is just unusual services. Unusual services would be things that are not typical if you use a laser, not that there's anything wrong with laser but that's unusual or typical, or if you do a high level or amount of neuromuscular reeducation 97112. Those types of codes will have a tendency to have more review because they're not typical. The other issue will be pattern billing. Pattern billing is where a provider will do the same services on every patient almost no matter what the diagnosis or condition will be. I will be careful in that sense that clearly a chiropractor is going to see a lot of patients with very similar problems. Obviously, musculoskeletal, neuromusculoskeletal where patients will receive manipulation and obviously some type of therapy services potentially, but we do want to be careful that [inaudible 16:03] appears to change at all. Here's an example of an audit from the company UMR, which is part of UnitedHealthcare. We just highlighted the areas that I have here in yellow. You'll see here what are the things they're looking at and it says, “Identical CPT coding pattern billing for nearly every patient for every visit i.e. the patients receiving 98941, 97530, 97124, and 97110.” Now, again, there would be nothing wrong with that combination of codes but if every patient on every visit gets it that would be unusual and hence why they would have a tendency to look. Notice also some of the other findings of this audit. Bullet number two indicates records are very vague and highly repetitive or canned content. You do want to be careful with electronic health records or some of the systems. They’re so simplistic that they'll often just clone or can documentation from one visit to the next. If that happens, of course, those notes are not going to be as specific and more likely to be denied.
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