BC Advantage - 2024 Issue 9

Types of Healthcare Audits

Healthcare audits are essential for analyzing operational compliance and adherence to quality standards. Also called clinical or medical audits, these processes generally assess where providers and staff are doing well and where they can improve. Audits in healthcare can support an improved patient experience, staff accountability, and healthier revenue cycle management (RCM).   However, they can also seem daunting due to the risk of exposure to improper billing or inaccurate documentation. These poor compliance practices can lead to revocation of billing privileges, exclusion from participation with payors, allegations of false claims, civil monetary penalties, and financial or reputation losses...

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