Coding & Compliance Tip

This week we are hoping to set aside the "don'ts", and "stop that's" and focus on what you should, and can do to reduce risk in your organizations. Effective compliance programs include several key elements that are considered to be "controls". A few of those core controls include; policies and procedures, training & education, and auditing & monitoring. While they are all essential, the most "important" control of these three is, auditing. Q: Why is auditing the most important of these controls? A: Because you can create policies, and you can provide training, but without auditing & monitoring to determine if they are effective, you might just be wasting your time. Unfortunately, we see a lot of push back in the industry when it comes to showing auditing the love it deserves in the budget. The truth is, external reviews should be an extension of the audits you are already doing internally. If you want to successfully reduce the likelihood of payer audits, and improper payments which by the way, include catching missed opportunities, you should ramp up your audit work plan.