Compliance Audits: Preventative Medicine for Your Practice

Written by Jennifer Hume, CPC, CPMA, CEMC, VP of Auditing & Compliance for AAPC Physician Services | August 30, 2010

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Imagine the patient who doesn't come to your practice until he is very ill. He's hospitalized, undergoing extensive procedures at a great cost. The sad part? His condition could have been prevented if he had come in for regular preventive care.

Compliance audits can be viewed in the same way. Practices that bill for services without taking the time to check to see if what they're doing is right are running the same risk as a patient who doesn't see his or her physician for preventive care services. They're gambling that everything is ok. That is, until something bad happens.

The need for compliance audits was first identified by the Office of Inspector General (OIG) in February 1998 when it published the first Compliance Program Guidance for Hospitals. In October 2000, the OIG published similar Compliance Program Guidance for Physicians and Small Group Practices. In all, a total of 11 Final Compliance Program Guidance documents have been published for a variety of healthcare providers, with supplemental guidance published for hospitals and nursing homes. A common element across all of the guidance published by the OIG is implementation of auditing and monitoring processes.

To read the complete column, published on the AAPC Physician Services website, click here.

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