decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Compliance / Step One_Auditing and monitoring
Subscribe or sign in to view the full article.
Article Overview
This article covers the auditing and monitoring component of a compliance program for medical practices. It discusses how organizations assess whether standards are current, whether claims and records are being handled appropriately, and how periodic review and follow-up fit into broader compliance oversight. The material is aimed at practices, billing staff, and compliance personnel who want to understand the general framework for internal review and monitoring.
Why This Topic Matters
Auditing and monitoring are central to identifying vulnerabilities in claims processes and maintaining an effective compliance program. For practices, this topic helps frame how to measure ongoing performance, support internal training, and respond to issues discovered during review.
What You Will Learn
- How compliance programs use audits and monitoring to evaluate claims handling
- The difference between reviewing standards and reviewing claim submissions
- How baseline and periodic reviews support ongoing compliance oversight
- What broad types of records and claims may be included in internal review
- How practices generally think about responding to issues found during auditing
Who Should Read This
- Medical practice administrators
- Billing and coding staff
- Compliance officers
- Healthcare auditors
- Physicians and clinical managers
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com