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Patient Payments Blog

Protect Your Practice With Third Party Professional Audits

Posted by Jim Turner

Nov 15, 2018 8:39:00 AM

Audits Are Pathways To Peace Of Mind!I know a few people in the practice audit business but none of them encouraged me to write this post, nor am I referring any of them to you. I’m writing this post because I follow healthcare news.



Everyday, no exaggeration, I see a new story concerning issues that cause practices to lose money - a lot of it. Or, in some cases, personal or practice reputation. In some cases doctors lose their privilege to practice medicine because they failed to exercise proper oversight.


There are many issues including theft through embezzlement or clever schemes, insurance inaccuracies and misuse, Medicare, or Medicaid fraud, patient data leaks, and the list goes on. But every day a practice like yours takes a financial, reputation, or personal attack that could have easily been prevented with annual or more frequent third party audits.


We are nearing the end of another year. It’s a perfect time to call in the kind of help a third party auditor can give. In each of these cases I recommend you spare no expense to obtain the best professional help possible. I encourage the following types of audits.


Financial Audit:  Find both a strict financial professional and then a healthcare specific professional. Why? Because industry outsiders that are good at financial order and proper bookkeeping can find things that others aren’t looking for. And healthcare specific professionals can suggest improvements to meet your benchmarks and keep you in line with federal, state, and local oversight agencies.


Workflow Audit: A workflow audit is simply an audit that studies how things get done and suggests how to do them more efficiently. The beauty of having an outside agency do these is that new sets of eyes discover things you won’t see because you are immersed in your day to day. You can obtain workflow audits for your entire practice or one aspect of your process.


Compliance Audit: Are you in compliance with all the contracts you signed and all applicable laws? That’s a big question that has many layers. Practices get in trouble with insurance companies because they have failed to adhere to the payor contract they signed - many of them signed several years past. A constant barrage of new laws to regulate every square inch of your practice needs to be analyzed and audited. Building and equipment leases often have little known consequences that your predecessor may not have been on the lookout for. A professional will sniff these out and protect your practice from known or unknown compliance issues.


HIPPA Audit: There are HIPPA audits and then there are HIPPA audits. We dread them but they are a special kind of necessary protection, so don't neglect them. You don't want your practice to turn up on the wrong end of a violation. Find the best professional to turn over every rock. Nobody likes a HIPPA surprise.


There are probably a half dozen more audits that could benefit your practice. Finding the most appropriate ones shouldn’t happen in a crises when an audit is mandated by some outside enforcement agency. Audits should be planned for and undertaken on a regular basis when the pressure is off.


Many practices turn up their noses at having professionals audit their business. Audits are intrusive. Audits take time. Audits uncover errors. Audits can feel personal. And audits are the necessary cost of doing business properly. A professional audit may uncover a ticking time bomb and save your practice a significant loss in money, reputation, and time. Today is the perfect time to begin a regular cycle of practice audits.

Topics: Healthcare Consulting, Medical Office Administration, practice management, Ideas

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