Providers cannot eliminate all risk, but can minimize risk through proactive approaches that involve training and policy development. Medicare audits have increased 1000% in the last 5 years! Are you ready for that level of scrutiny? To help analyze your risk, identifying WHO is responsible for the following areas and establish a schedule of review to build your compliance foundation:
- MDS coding and accuracy? Avoids payment returns and supports billing process
- Training? How often? What topics? Keeps everyone knowledgeable and focused on current guidelines
- Audits? How often? Opportunity for improvement plans resulting in improved processes
- Review of Provider agreements and Federal guidelines for coverage guideline updates? Prevents errors in billing for services outside of the coverage guidelines
- Database content? Who monitors this? How often? Protects the integrity of your organization
Audits such as new survey protocols focusing on MDS accuracy, new analytics and increased ability to data mine are occurring in conjunction with active interagency reporting, so establishing internal audits to confirm practices helps safe guard your organization from a negative outcome.
COMPLIANCE IS EVERYONES RESPONSIBILITY