Practolytics’ Compliance Audits will Strengthen Your Healthcare! Here’s Why

Compliance audits are an everyday occurrence if you operate in a regulated industry. Compliance can be difficult and audits can be intimidating without proper systems in place to follow current standards.

In the healthcare industry, auditing is a systematic and objective process that reduces risk. Healthcare compliance necessitates objectivity and accountability via independent auditing boards and institutions. A healthcare compliance audit assesses the program’s strengths and shortcomings.

What Exactly Is a Compliance Audit in Healthcare?

Healthcare compliance audits are followed up by reports that contain preventive steps and system adjustments to boost security while minimizing risk. By following healthcare compliance standards, rules, and laws as well as implementing audit recommendations, institutions and providers may decrease mistakes, promote patient safety, and offer the best possible care.

The primary purpose of compliance auditing is to assess if a practice is in compliance with regulatory rules, security protocols, and risk management practices.

What You Should Know About HIPAA and OIG Compliance

HIPAA

In today’s healthcare sector, information rules the world. Unfortunately, criminals value healthcare data as well. Malicious attacks aimed at obtaining patient information and breaches of Protected Health Information (PHI) are on the rise. With breaches increasing at a 25% yearly rate, healthcare organizations must strengthen their defenses. To secure how organizations utilize, distribute, and manage patient data, advanced processes and technology must be implemented.

Due to the COVID-19 pandemic, telehealth has significantly increased and so has increased sharing of patient information via remote patient/provider interactions and observation.  With these modifications, new HIPAA laws and regulations governing technology prioritize patient privacy while also controlling the use of technology and online prescription guidelines.

Noncompliance carries serious penalties for the organizations.  If discovered to be noncompliant, the healthcare organizations face fines, reimbursement delays or denials, and litigation, which might involve criminal charges and incarceration. To prevent financial and reputational damage, your healthcare business should conduct HIPAA compliance audits on a regular basis to discover weaknesses in data protection and practices.

OIG

Noncompliance with the OIGs regulations and policies can have serious penalties, including but not limited to:

• Exclusion from government-funded health-care programs.
• Penalties, both civil and criminal.
• Report to the provider’s state medical board.

The Office of Inspector General (OIG) offers healthcare compliance services to assist businesses in navigating continuously changing state legislation and compliance standards.

Compliance Programs Driven by Technology

Healthcare is one of the most strictly regulated sectors, and keeping up to date on regulatory developments is difficult. Although technology has exacerbated the difficulty of keeping data secure, it also presents various choices for protecting that data. Increased demands for healthcare security and compliance can be met with automated notifications and continuous monitoring of technology. Integrating technology that monitors and audits your provider base on a regular basis allows healthcare organizations to ensure that they are providing quality treatment. Automatic reminders that alert organizations to noncompliance help address any issues swiftly and efficiently.

How Practolytics Can Benefit Your Practice

We strive to provide services that will allow you to spend more time caring for your patients. While you are doing that, we will ensure that denials are reduced, regulatory compliance is followed, and income is increased. All of this would be done in accordance with payer and government guidelines.

1. Reviewing Medical Charts

You can boost efficiency, decrease risk, and prevent revenue loss with our prospective and retrospective multi-tier chart reviews. With a staff dedicated to your expertise, patient group, and location of service, we assist discover and correcting shortcomings before they become problems.

2. Services for Document Improvement

You may shield yourself against negative cash flow by using our documentation enhancement services. Our specialists will help you improve DRG accuracy, identify lost inquiry opportunities, reduce clinical risks, improve patient care and outcomes, and more.

3. RCM – Revenue Cycle Management

You can improve the entire health of your revenue cycle with our integrated solutions. We examine your revenue cycle’s shortcomings and strengths, and build personalized solutions to ensure efficiency, consistency, and maximum earned reimbursement.

4. Post-Audit  Training

Overcome reporting gaps in your workplace, whether they are the result of evaluation and management coding, encounter information, medical need, grade of specificity, visit data, or guideline criteria. Our customized training services deliver measurable outcomes and will guide your team through the reimbursement and legal regulations. Our expert team of trained programmers, auditors, and trainers will get you started on the right track, enabling you to:

• Acknowledge and fix documentation gaps
• Enhance EHR uptake
• Identify possibilities for process improvement

What Sets Practolytics Apart

Practolytics’ depth of knowledge in healthcare operations, compliance, data analysis, and revenue cycle management makes us particularly qualified to give valuable analysis and recommendations.

Our team members have professional backgrounds working in provider organizations and government bodies. We have an unrivaled understanding of healthcare institutions ranging from individual providers to hospital systems.

Please contact Practolytics right away to learn more about Healthcare Compliance Audits and how we can help your practice.

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