Healthcare Audit Fundamentals

Case

You are a compliance officer working at Around the Bend Clinic, an acute care facility in a rural area. Around the Bend is preparing for an audit of its revenue cycle. As a compliance officer, you are responsible for knowing about the various types of audits associated with healthcare organizations, including the components of each audit. You have been tasked with creating a training resource to prepare your coworkers for the revenue-cycle audit process.

Directions-For this project, you will create a training resource to inform staff members about an upcoming revenue-cycle audit.

Specifically, you must address the following:

· Healthcare Audit Fundamentals: To begin your training resource, you have decided to provide an overview of the different types of audits for healthcare organizations. In your overview, be sure to address the following:

· Describe the various types of audits, both internal and external, that are applicable to healthcare organizations. In describing these elements, consider following:

· How are internal and external audits of healthcare organizations different?

· What are some of the common internal and external audits that you will encounter while working in healthcare organizations?

· Describe the regulations that are associated with the various audits of healthcare organizations. Consider the types of regulations that govern both internal, as well as external audits of healthcare organizations.

· Healthcare Audit Data: In this section of your resource, you will review how data are used in healthcare audits, using a sample Third-Party Accounts receivable report. In your overview, be sure to address the following:

· Describe how data are utilized by an organization in healthcare audits. Consider the following:

· Which data are important to a revenue-cycle audit?

· How are the different components of the accounts receivable report used to inform an audit?

· Describe how to establish parameters for collecting benchmarking data in healthcare audits. Consider the following:

· How do you determine which data are appropriate for benchmarking?

· What should you consider when setting parameters for benchmark data?

· Healthcare Audit Billing Compliance: In this section of your resource, describe the components that make up a billing compliance plan and its role in a healthcare audit.

You must submit the following:

Revenue Cycle Audit Training Resource Develop a training resource to inform staff members about an upcoming revenue-cycle audit. Your training resource should consist of a PowerPoint presentation (5–8 slides) with speaker notes (500–1,000 words) that provide necessary context for your slides. Alternatively, you may create a pamphlet or other visual resource. You may submit your file as a Word doc, PDF, or PPT.