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Conducting Medical Chart Audits

A chart audit is an in-depth examination of medical records to ensure that all ancillary services, surgical procedures, supplies, medications, etc. were ordered & delivered to the patient as charged and promoting accuracy and integrity of hospital charges and assist in recovery of lost revenue.


Both internal and external audits are critical to maintaining the fidelity and compliance of your medical billing processes. However, they need to be conducted thoroughly if they are to be of any value. Medical chart audits ensure that issues are caught ahead of time so that there aren't any surprises.


Develop a System of Accountability

Each facility needs to create a system of accountability. A system of accountability doesn't have to be punitive; it isn't intended to "punish" those who perform badly. Instead, a system of accountability provides guidelines regarding what they are and aren't responsible for. Too frequently, audit findings are not distributed to the correct people, leading to the same errors occurring time after time.

Create the Proper Controls

An audit isn't just designed to catch mistakes; an audit is also designed to prevent these mistakes from happening again. Whenever errors are caught in an audit, a corrective action plan needs to be put in place for each revenue generating departments in order to conduct an assessment and improve results. Once suggestions have been made, a Focus audits needs to be conducted to determine areas for improvements and to ensure that these new controls have been implemented and that they have successfully resolved the issues that were caught. As audits continue, these controls should ideally be fine-tuned and refined.


Set Benchmarks for Improvement

In addition to catching mistakes, audits also isolate ways to optimize and streamline current operations. One of the easiest ways to refine your medical chart operations is to set actionable benchmarks for improvement. As internal audits continue, these benchmarks can be assessed, and it can be determined whether the billing system is improving as it should. Reminder, there is no system that does not involve some level of human error.


Utilizing Third-Party Medical Chart Auditing Service

Though internal audits are important, regular external audits are still necessary. An external audit conducted by a third-party is critical as it can generally provide a more thorough audit. A third-party audit service provides a system of checks-and-balances and may even be necessary for the purposes of showing compliance to the appropriate medical regulations.

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