Posts Tagged ‘auditing’
In medical mergers, due diligence is essential
Firms must be deliberate and careful, especially when consider a merger or acquisition. Medical Due Diligence audits can help.
Read MoreThe Two Sides of Post-Payment Audits & How You Can Make the Process Easier
Payer audits are a necessary step in the health information management field. These post-payment audits ensure the provider is compliant with the payers’ requirements and that the correct reimbursement amount was issued.
Read MoreYES HIM Consulting Recognized By KLAS Research With First Look Report
Signaling a great achievement for YES HIM Consulting, the health information management company has been recognized by KLAS Research with a First Look Report. KLAS compiled the report after speaking with 9 individuals from 8 client organizations about YES services.
Read MoreWhat Does It Mean for Medical Coding Companies to Have a 100% Client Retention Rate?
Outsourcing no longer means time-zone hopping overseas to find reliable, skilled, and affordable medical coding and auditing companies dedicated to achieving high coding productivity and quality standards. It is increasingly common for healthcare organizations to outsource coding overflow and quarterly audits by sourcing talent from a U.S.-based company. YES HIM Consulting is proud to be a premier coding, auditing, and education preferred partner to large-scale healthcare systems, individual hospitals, physician groups, and more around the U.S.
Read MoreMaking the Data Work for You: How to Turn Medical Coding Audits into Actionable Insights
Coding audit data can be extremely beneficial to the success of a healthcare organization – however, oftentimes, the vast amounts of data being collected can suffocate the organization, especially those that don’t know how to cultivate value and act on the insights received from the audit process. Most medical coding compliance audit programs will objectively evaluate multiple data sets and generate reports on the findings, but, the data is not being used to its fullest potential if the reports are not properly cleaned, analyzed, and examined to develop strategic next steps toward the company’s quality improvement. “Data and quality improvement go hand-in-hand”, says Crumbley.
Read MoreWhat to Expect in Due Diligence Audits & How to Find the Right Auditing Vendor
The healthcare industry sees hundreds of facility acquisitions and mergers every year (PwC, 2020). A critical part of mergers and acquisitions is the due diligence process, which provides a complete financial and performance picture of a healthcare organization to ensure it is a sound investment. Every aspect of the facility, including the physicians, coding, property, finances, and more, are reviewed. In addition, M&A due diligence audits highlight potential liabilities and coding quality issues.
Read MoreCoding Audits: How Identifying Issues Sooner Rather than Later Saves Money for the Hospital/Facility
The establishment of a coding compliance program remains a significant effort by the Office of the Inspector General (OIG) in its attempt to engage the healthcare community in combating fraud and abuse. The OIG developed a Compliance Resource Portal with materials and guidelines for healthcare professionals. A fundamental element to an effective compliance program is conducting internal monitoring and auditing. Coding audits have the added value of ensuring you are running an efficient and profitable, not to mention minimized liability, operation. Earlier detection of any potential coding issues will pay off financially and will reduce risks for additional external audits.
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