HIM 360 Module Four Audit Summary Report Template
Detailed Analysis: [Clinic Name]
Reviewer: [Your name – duplicate this on each page]
Date of Review: [Today’s Date]
Number of Reports Reviewed: [Number here]
Provider Audit Score: [%] accuracy rate
[Start by filling out the table below that starts on page 2. Then, calculate the accuracy rate above. Finish
by writing your 1- to 2-page report here. Include a review of the audit performed, the details of the
audit, the charts audited, and the findings. Identify problem areas and suggest improvements. All of
these elements are explained in your short paper rubric as well.]
Page of 1 2
Physician: #1 [Today’s Date]Date of Review:
Reviewer: [Your Name]
Number of Reports Reviewed: [Hint: This is the number of reports listed on the Excel spreadsheet.]
Patient Diagnosis
Present on
Admission
CPT Billed CPT Documented Status: Correct or
Error
