Internal auditing: Considerations for coding compliance and education

Why This Topic Matters

Internal audits are a core tool for identifying coding and documentation problems before they become external audit or compliance issues. Understanding the article helps coding and compliance teams recognize the kinds of regulatory and educational topics addressed in internal review programs.

Article Sections

1. Overview: Internal audits

   Introduces internal audit functions, reviewer roles, and the general focus of claims and documentation review. It also summarizes the kinds of compliance resources and professional backgrounds associated with audit work.

2. Educating providers on coding, documentation compliance

   Discusses the education goals that follow audit findings, including broad fraud-and-abuse awareness, federal compliance concerns, and key reference sources used in coding education.

3. Responding to provider push-back

   Covers general communication strategies for addressing provider objections to coding feedback. It describes common themes in provider resistance and the importance of professional, consistent education.