The number of auditing agencies and their sphere of influence has grown substantially in the past ten years. You almost need an atlas to keep them all straight. The Office of the Inspector General (OIG) investigates fraud and abuse, Recovery Audit Contractors (RACs) monitor hospitals for billing errors, Medicaid Integrity Contractors (MICs) look for Medicaid overpayments, and Zone Program Integrity Contractors (ZPICs) look for Medicare fraud and abuse, hospitals have been monitored and audited for billing errors far more closely. The need to be vigilant in performing internal audits of your organization has never been greater.
MDaudit Hospital was designed to streamline and automate your auditing and compliance efforts. It allows you to quickly analyze and measure your organizational risk, focus and monitor specific risk profiles, target audits and focus quality initiatives and education around findings. By proactively auditing your organization you can take corrective measures to ensure accurate billing, revenue retention and compliance with federal regulations.
Other features of MDaudit Hospital include:
- Audit profile creation – you can create audit profiles by high risk areas, such as diagnosis or treatment or by regulatory targets for assessment and intervention
- Clinical document improvement – allows you to randomly select documentation for review and target critical areas for improvement
- Correct Coding Initiative – Uncovers coding disparities and conflicts with all levels of diagnosis and procedure codes, ICD-10, CPT, HCPCS and LCD
- Standard and customizable reports – produces standard management reports and allows you to customize reports based on your specific audience whether it’s internal or external
- Central database – allows you to record findings and keep a running history to return to for follow-up
- Risk assessment and sampling – allows you to analyze billing data and obtain a random sample for review, then crosswalks to medical record to determine billing and documentation accuracy
- Billing data access – the billing data interface was designed by coding auditors for ease of use
But perhaps most importantly, MDaudit Hospital streamlines your auditing and compliance efforts to mitigate your organizational risk and financial exposure.