Conduct Self-Audits Adeptly With This Expert Advice

Why This Topic Matters

Self-audits are a core part of an effective compliance program, especially when claim scrutiny increases. Understanding how to structure audit frequency, sampling, and trend analysis can help practices monitor risk and evaluate whether education efforts are improving documentation and coding performance.

Article Sections

1. Audit Planning and Risk Assessment

   Introduces the need to update audit policies and build a risk-based audit plan in response to increased claim scrutiny. Explains the role of internal audits within a broader compliance program.

2. Compile Your Data for Review

   Describes gathering utilization and chart data to begin an audit review. Covers using observed patterns to determine the scope of initial chart selection and further sampling.

3. Calculate Your Findings

   Focuses on reviewing audit results and measuring coding and documentation performance. Discusses how the size and type of sample can affect the review process.

4. Base Audit Timeline on Results

   Covers setting an audit schedule based on measured performance over time. Addresses how organizations may adjust audit frequency according to internal review outcomes.

5. Utilize Trends to Devise a Long-Term Plan

   Discusses trend analysis as a way to track performance across review periods. Emphasizes using audit information to evaluate the impact of education and training.