Corporate Compliance

Tip: Use monitoring tool to facilitate by-department reviews

Healthcare Auditing Weekly, March 3, 2009

The monitoring tool is perhaps the most important document in your compliance-monitoring toolkit. When properly drafted, it allows an average employee with minimal training and no support from the compliance office to conduct a miniature compliance audit.

Straightforward questions, well-defined rules, and standardized responses help to avoid interpreter error and facilitate post-audit analysis, particularly when relying on electronic tools. The following are sample monitoring-tool questions:

  • Is the physician order for services present?
  • Does the physician order contain all required elements?
  • What is the reason the physician provided for ordering a test?
  • Do the billed charges match physician order?
  • Does the medical record documentation support the charges billed?

This tip was adapted from Guide to Monitoring: Tools and Strategies to Enlist Department Managers in Hospital Compliance. For more information on this book and HCpro’s other compliance and auditing products, visit the HCMarketplace.

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