Healthcare Compliance Audits

Healthcare compliance is an important element of medical billing which ensures the quality of treatment rendered to patients. Preparing for an audit is like being prepared for a big game. During the time of audit, the opposite team might throw a curveball that you did not practice for. Providers can easily dodge any unprecedented move by partnering with medical billing services.

Ultimately, in the end what matters is your readiness and your ability to execute every move to win the game.

In this blog we will talk about strategies and tools that will help your organization to minimize stress, ensure compliance, and stay on track for easy healthcare compliance audit preparations.

Determine the Gaps in Compliance

The most common step in healthcare audit preparation is to identify and address gaps before they become an issue. One way to do this is to conduct an internal audit within your organization. This also helps you create efficient revenue cycle management. An internal audit helps you find the discrepancies early without the fear of repercussions.

For example, exploring proper coding and financial practices is the first step towards improving them. Once you know the vulnerabilities of your organization, you can rectify them before it leads to a significant problem.

Providers can also rely on data and reports to find the gaps in compliance. For instance, evaluating an incident report can help you identify the process or training issues for a department or location. During this you may come across an issue like a particular department has far more barriers than other departments and only half of those employees have completed the required training.

Going through raw data or using a spreadsheet can be a tedious process when there’s large volume. Using such reports that highlight the gaps, one can quickly identify and resolve the issues for easy healthcare compliance audit preparation. Partnering with efficient medical billing services is a great way to decrease the hassle.

Focus on Document Management in Advance

Keeping up with the regulatory changes and managing documentation are two of the most significant challenges in maintaining compliance for healthcare organizations. Effective document and policy management can keep things organized throughout the year for a easy healthcare compliance audit preparation.

Up-to-date with policies

Providers must create a comprehensive process to track when a policy needs to be updated. This will give you access to a report where you can see the expiration dates, along with automated reminders to make sure that any new update does not slip through the cracks.

Make Policies Accessible

An organized and easily accessible library of policies benefits everyone. During a healthcare compliance audit, it is easy for you to fulfill an auditor's request, and employees can double-check if they are asked something they are not sure about. This is a great way for revenue cycle management.

Track Everything

Make sure you have a documented version history, employee acknowledgements, and board approvals in case someone asks you a question.

Stress-free and easy healthcare compliance audit preparation is done best with an extensive policy management solution. If you are storing documents and policies in one place, send them for signatures to another place, and then pull data together on track. This becomes a huge hassle for providers which is time-consuming as well as prone to errors.

Leverage Compliance Tools

A lot of healthcare organizations have adopted technology for simplified healthcare compliance audit preparation. Some accredited surveyors say that the most prepared organizations use online healthcare compliance management platforms which showcases that the organization prioritizes compliance and will typically have policies, documentation, and a prepared staff which is ready for accreditation.

A good compliance tool brings the entire workforce compliance tasks into one platform to work together. The visibility and automation provided by technology provides a peace of mind and a stress-free experience. For instance, automated reminders keep you on top of expiring credentials, policy acknowledgements and overdue training, so they are completed in a timely manner.

Customizable reports and dashboards help you keep an eye on the status of training, exclusions, and more. These tools help healthcare organizations remain audit-ready all year round and mitigate the stress that can happen at the last minute.

Prepare Your Team

A well-prepared team is able to answer all the questions and fulfill surveyor requests quickly and accurately. This gives surveyor confidence in your compliance. It is a great strategy for simplified healthcare compliance audit preparation. When you are not able to locate information or easily answer a question, the surveyor will keep digging for it.

Prepare your team for all sorts of questions they may get asked and make sure that everyone has access to documents and policies so they can refer to those in need. The preparation of your team can create the difference between being technically compliant and survey ready.

Even if your staff has all the documentation prepared, without proper knowledge they might be subject to complex questions that they might get confused with. If the auditor is not satisfied with the answers, they might put your name in non-compliance.

Prepare your staff to check what the policies say if they are in front of a surveyor and they are not sure how to answer a particular question. You can use the information you got while identifying your compliance gaps for simplified healthcare audit preparation.

Develop an Action Plan for Audit Day

An efficient and well-planned healthcare audit ensures smooth coordination, compliance verification, and the readiness to address the auditor’s request.

Here is a detailed action plan.

Pre-Audit Morning Prep Before Auditor’s Arrival

Make sure that all the relevant team members are aware of the visit.

Make it a point that your compliance software is easily accessible, including electronic health records or credential files.

Create a quiet and comfortable space for auditors with access to required documents and office supplies.

Auditor Arrival

Document the auditor’s entry into the facility as a strict security protocol. This shows you are serious about adherence to compliance.

Give a small introduction of the facility and major points of contact to the auditor.

During the Audit

Take the auditors to the location and departments they are requesting. Present the requested documents efficiently, which ensures that they are organized and complete.

Keep copies of any and all documents provided for internal records.

Document all the questions asked and address any red flags for feedback.

Post Audit Debrief & Next Steps

Conduct an internal debrief with the team, reviewing findings and any immediate concerns.

Identify potential areas of improvement for further audits while addressing minor issues identified and plan for long-term compliance improvements.

Create a response plan in case a formal corrective action report is needed.

Bottomline

Preparing a healthcare practice for audit is a tough battle, especially when so many compliance policies are involved. Without a proper compliance structure, no organization can be adherent to all the compliances in place. Even the slightest nonadherence will put your practice in a lot of trouble. This is where professional medical billing companies like Unify Healthcare Services can help your organization.

Unify Healthcare Services has a team of experts who are well-versed in all the elements of medical billing and coding. We are always updated about the latest medical billing compliance. We can help you manage both front-end & back-end revenue for your organization. Our experts will make sure that you are always compliant with the latest billing guidelines for healthcare practices. We understand that being non-compliant can be a big hassle for healthcare providers, which is why we do not only provide our services; we provide mental peace.