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 Practice Management Tips Practice Compliance Plans At the heart of Practice Compliance Plans is internal auditing. These audits are designed to identify problems and document progress. When considering internal audits take into consideration the following suggestions: Keep internal audits within the capabilities of the practice. Tip: The purpose of audits is to determine if problems exist or if progress is being made. It is not necessary to have a frequency of audits or a complexity of audits that goes beyond the purpose. Take into consideration the time, effort, resources and expense of the audit. It may be justifiable to have an annual comprehensive audit of policies, procedures and charts. It may make more sense to have limited audits of different segments of the practice. Internal audits do not have to be of just medical records. Tip: Medical records reflect the ways patient care is provided in the practice including paperwork flows. Audits can be directly done of the paperwork flow. If a problem is identified, such as having unqualified staff identifying diagnosis codes, a selected audit of charts can be conducted. Desk audits are very efficient ways of conducting limited studies. Tip: Use a desk audit to review the results of the billing work. The purpose is to identify trends and potential problems. For example a desk audit could gather statistical information on levels of Evaluation & Management codes used for different diagnoses. It may be found that one physician codes at very different levels for the same diagnosis than another physician. This would then lead to a very specific chart audit that is much more focused. There are other ways to conduct internal audits. Tip: In addition to desk audits, surveys can be conducted to find out how different aspects of the practice are being conducted. For example, you could survey employees about their observations (needs to be anonymous). Other surveys might include how different people would handle different problems. How might this then affect policy and procedures? Policies and procedures can be audited through interviews and direct observation. There are numerous subjects that may be audited in these limited audits. Tip: Audit subjects could include potential false claims violations (claims related), Stark violations (compensation agreements), handling of Medicare refunds, forms used for documentation of services, methods of collecting information for out-of-office services, advertising and promotional/educational materials, etc. Once audits are completed and some results have been identified the next step is to provide education to those who need it. Save all the records of your audit and document all training, education and disciplinary efforts that are made.
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