Learn from OIG coding audits and take steps to prevent denials

Why This Topic Matters

Organizations can use publicly available OIG audits to learn where compliance risks tend to arise and how internal audit programs can be targeted more effectively. That matters because better audit planning can support early detection of issues, more consistent monitoring, and stronger compliance operations.

Article Sections

1. How to identify risk areas

   This section discusses broad ways organizations can recognize potential compliance and billing risk areas before building an audit plan. It also references common sources used to inform risk assessment and audit prioritization.

2. How to select the audit sample

   This section outlines general considerations for choosing an audit sample and organizing it around identified risk areas. It also addresses the relationship between routine monitoring, statistically valid sampling, and audit policy structure.

3. Selecting the records

   This section describes the process of narrowing records from a defined universe for review and mentions common tools used to support sample selection. It focuses on operational handling of record selection within an audit workflow.

4. Reporting results

   This section covers how audit results are communicated, reviewed, and finalized. It also notes the need to address discrepancies and related financial findings within the compliance process.