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TYPES OF MEDICAL COMPLIANCE AUDITS

By Carol Miller RN MBA

There are several types of audits that a healthcare organization might need to perform.

The starting point is to obtain a baseline audit.  Next steps include periodic audits or reviews that are performed after all the information is obtained from the baseline audit; periodically. Finally, there are new employee audits.

Additional audits can be performed whenever new employees are added or if there are complaints or issues that arise in the course of business.

The Types:

• Self Audit. Routine self-assessments demonstrate proactive measures established to ensure compliance and thus reduce the likelihood of a failed audit
• Baseline Audit. Baseline audits are preliminary assessments to develop a reference point. This preliminary audit can help an organization understand where the program is and establish a base to gauge or compare future activities. Without this initial assessment, it is difficult for anyone within the practice or even an external consultant to determine if there are any performance issues.
• Periodic Audits. Periodic audits are performed on an on-going basis, based on the decision of the practice. They may occur at random or at a scheduled time, monthly or quarterly.
• New Employee Audits. New employees require regular training and reviews until there is confidence in their capabilities. Background checks are helpful to find out whether there are any potential conflicts; however, many independent medical practices do not have access to this type of information and may have to rely on other organizations to obtain the information. The OIG and General Services Administration maintain a database of excluded persons and entities that can be accessed through the internet. As part of the organization’s initial and periodic audits, queries of these two databases should be performed for all employees and any independent contractors.

Conclusion

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OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:

• PRACTICES: www.BusinessofMedicalPractice.com
• HOSPITALS: http://www.crcpress.com/product/isbn/9781466558731
• CLINICS: http://www.crcpress.com/product/isbn/9781439879900
• ADVISORS: www.CertifiedMedicalPlanner.org
• FINANCE: Financial Planning for Physicians and Advisors
• INSURANCE: Risk Management and Insurance Strategies for Physicians and Advisors
• Dictionary of Health Economics and Finance
• Dictionary of Health Information Technology and Security
• Dictionary of Health Insurance and Managed Care

 Harvard Medical School

Boston Children’s Hospital – Psychiatrist

Yale University

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Filed under: Risk Management | Tagged: Carol Miller RN MBA, healthcare audits, medical practice audits | 1 Comment »