Provider organizations well know of the realm of financial billing audit programs with insurers that they have to deal with. What get less attention are newer audit programs for HIPAA privacy/security, electronic health records meaningful use and soon ICD-10 compliance.
The time is now to start identifying and prioritizing risk, and to standardize best practices, says Aurae Beidler, director of the healthcare compliance certification program and an assistant professor at Pacific University in Hillsboro, OR.
Providers, she asserts, need to be taking a look at whether their audit-related workflows are efficient and have internal controls that support compliance, whether the right people are doing the right tasks, and whether the board of directors is aware of audits and risks. If an organization’s Medicare RAC is finding things an internal audit didn’t find, it’s time to take a look at internal auditing.
On the matter of HIPAA privacy/security audits, Beidler will recap the HHS Office for Civil Rights’ pilot audit programs, their findings and next steps for OCR. Whether HIPAA, payer, meaningful use or ICD-10 audits, getting better prepared for them now will bring dividends in the future, Beidler says. “These audits take resources and time away from product production and coding time. They take time and resources you don’t have.”
Education session 10263, “The Changing Landscape of Regulatory Audits: A Survey of Hot Topics,” is scheduled at 10:30 on October 30.
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