Practice Audits [Healthcare Compliance Tips]

Audit your practice annually to avoid the exclusion list, penalties, and investigations.

In the opening of our series called “Compliant or Complacent,” I shared why being uncomfortable will push your practice to the next level, which includes performing:

Practice Audits

In SAI Global’s 2021 Healthcare Compliance Benchmark Survey, 40% of respondents state they have not performed an independent evaluation of their program in three years.

Per the OIG, auditing is part of the seven elements of an effective compliance program and determines the non-compliant areas within your practice. Coding, billing, HIPAA, OSHA, and HR are all examples of audits that can be performed at least annually.  Thereafter, you can use the results to craft policies and procedures for your specialty.

A best practice is to hire a consultant to perform the audit.  The benefits of hiring a consultant are unbiased results, peace of mind, and better return on investment.  If you decide to go this route, I suggest you educate yourself on the audit process because you are still responsible for any errors per the OIG.

Here are a few questions you can ask during the consultation:

• Do you have an outline of the audit process?
• What type of records or sections will you audit?
• Are you ok with our practice providing you a list of previous risk areas? What risk areas do you normally see?
• How many records will be audited?
• What type of audit tools or reports will be provided?
• Will you share tailored recommendations?

Consistent audits show your practice is making a good faith effort towards following regulations or submitting claims correctly, which plays a role in patient care and protecting taxpayer dollars.  Sharing the results with employees is recommended because focused training will benefit your practice.

Remember, each time you choose to skip auditing, you risk being placed on the exclusion list, subject to penalties, or investigations by the federal or state government. Choose wisely and audit at least annually before the government pays you a visit.

**The opinions and observations from the group/author are not a promise to exempt your practice from fines and penalties.  Research, modify and tailor the advice to fit your specialty.

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