Medical auditing is the process of reviewing medical records and processes to ensure they comply with regulations set by insurance companies.
This involves checking that clinics and hospitals adhere to the high standards of care mandated by the government. In addition, the process ensures that no harmful or unnecessary procedures is being done to patients.
Importance of Medical Auditing
Auditing helps clinics and hospitals ensure that they’re submitting the proper medical codes to insurance firms. It also helps avoid legal issues which, in turn, allows them to save money while upholding their reputation as a reliable healthcare provider. Many auditing companies can help healthcare providers spot reimbursement errors or deficiencies. Auditing companies can also identify opportunities for appropriate compensation, hence maintaining a positive cash flow.
Auditing is done in two ways: one-time and recurring. In one-time auditing, hospitals and clinics hire an expert who will evaluate records and processes and identify any existing and possible issues. He can then use these information to help them come up with ways to correct mistakes and prevent future problems. One-time auditing is helpful, but its effectiveness wanes over time since new records are always produced, existing ones are constantly updated, and processes change over time. To maintain accuracy and precision, medical practitioners must invest in recurring auditing.
This type of auditing takes place on a regular schedule. The auditor goes through the healthcare provider’s records on a monthly, quarterly, or annual basis. This depends on how many patients the clinic or hospital sees and how many transactions it processes. This type of auditing is the right choice for healthcare practitioners who don’t have their own auditing staff. It’s also ideal for businesses that see numerous patients in a day and deal with different insurance providers. By working with a recurring auditor, clinics and hospitals can focus on their core competency (i.e. taking care of patients).
It is important if Medical auditing if done either once or in a recurring basis. If you run a medical practice, start looking for a skillful and experienced medical auditor now.