A filing cabinet that's open and one person is handing a stack of folders/files to another. Increased Audits Could Equal A Streamlined Response for Healthcare Organizations

Increased Audits Could Equal A Streamlined Response for Healthcare Organizations

Many Healthcare Organizations and hospital systems are moving towards a more systematized, shared response as more and more state and federal program-integrity contractors get ready to unleash their auditing power. Among the amalgam of acronyms that have emerged with the evolution of healthcare reform are: RAs, the comprehensive error rate testing (CERT) contractorderal, zone program integrity contractors (ZPICs) and HHS Office of Inspector General (OIG) auditing machine. Let’s discuss the benefits of increased audits and how they could equal a streamlined response.

It is no surprise that consequently, several organizations have begun to create corporate-level regulatory response support teams. The goal is to streamline what has been taking place at individual facilities and to introduce more standardization as a means to improve the communications network, data analysis, and corrective action.

Yet it is rather hard to ask senior management to spend money on something that only in theory produces revenue. The idea is that proactivity will prevent problems in the future.  Systematizing across various facilities can potentially deliver better compliance, quality, and efficiency. Creating committees that include case managers, RA coordinators, coders, and billers among other relevant staff to make sure that site-specific issues and requests are being addressed and responded to will help with audit issues going forward.

Increased Audits Provide Much-Needed Benefits For Healthcare Organizations

Audits play a pivotal role in fortifying the foundations of healthcare organizations, offering a multitude of benefits that extend beyond mere compliance. Firstly, audits serve as a robust mechanism to ensure adherence to regulatory standards, safeguarding against legal and financial risks. By scrutinizing processes and documentation, audits identify areas for improvement, enhancing the quality of patient care and overall operational efficiency.

Furthermore, audits provide a structured means to assess and enhance internal controls, reducing the likelihood of errors and fraud. The insights gained from audits empower healthcare organizations to optimize resource allocation, improve workflow, and streamline operational procedures. This proactive approach not only safeguards against potential issues but also fosters a culture of continuous improvement.

Corporate Regulatory System Should Unify The Healthcare System

The corporate regulatory response team should serve as a uniting force throughout the health system, a team who can anticipate, identify and fix problems, and who can ensure nothing falls through the cracks. Consistency in the interpretation of policies and procedures and uniformity in how an issue is resolved can lead to dollars saved and a more efficient operation system-wide.