Anyone doing EPSDT or HealthStart audits?

EPSDT is Early Prevention Screening and ?? I forget what else it stands for, I can write in from work one day. It is essentailly a well child visit. It is a program of what the fed and state governments expects to be done for children to prevent illnesses. There are certain things that are supposed to be checked at certain ages/stages. Like CBC and PPD's, and lead screening, etc...

HealthStart is a simliar concept but dictates Maternity care standards. Like what prenatal labs are done, nutrition, psychosicial, and health ed , updates q trimester for some things, etc..

I work for a managed care company, and we go to doc's offices or clinics and review, or audit, the charts of our members to ensure they are getting quality care. We sign a contract with the state to say we will ensure our doc's and clinics/providers follow these guidelines and provide the same standard of care, so we have to do audits to prove it.

I am now doing Medical Record Review audits, basically this is a non-clinical audit, I am simply making sure lab results are signed as read by the doc, consults ordered are in the chart, there is a name or ID on each page of the chart, and if they have hippa and advanced directive info etc... I can tell you right now, only ONE doc of all the ones I did so far have a way to identify if people have an advanced directive, so I am making copies of the state law and handing them out at each site visit, suggesting for now that they make a question on a label and slap it onto their registration forms until they get a chance to re-print them or add it elsewhere.

It is really eye-opening to see how some docs chart and how some don't.

I like this job very much, except this week has been really heavy traveling, and today it rained, so traffic was out of control. It took me twice as long to get where I was going, very aggravating. I had some serious road rage today!