Formal vs. informal audits
Healthcare Auditing Weekly, January 16, 2007
When designing an audit, you need to know whether you will conduct a formal review/audit or an informal review/audit. Do you know the difference?
Formal reviews and audits involve carefully selected areas, outcomes, and samples. Informal reviews and adits are generally much smaller and performed on an ad hoc basis.
Consider the following when designing your audit:
The guidelines or standards you may use may be quite involved. For instance, coding-documentation reviews and/or medical necessity reviews may depend significantly upon internal organizational standards or external standards and even benchmarks. If you are reviewing observation coding and charging for medical necessity, then the hospitals care paths in this area will probably be used as guidelines.
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