Tip: Areas to audit
Compliance Monitor, March 5, 2008
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The OIG recommends hospitals conduct regular audits. Either internal or external auditors with expertise in government healthcare requirements can conduct these audits.
The audits should review external relationships with third-party contractors, specifically those with substantive exposure to government enforcement actions. At a minimum, audits should address the hospital's compliance with laws governing:
- Kickback arrangements
- Physician self-referrals
- Current procedural terminology
- Claim development and submission
- Reimbursement
- Cost reporting
- Marketing
This tip was adapted from the Compliance Program Effectiveness Handbook. For more information about the book or to order your copy, click here.
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