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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