clopez
Networker
Auditing: When is it safe to conclude an audit when there are to many cases to audit
Hello,
Seeking guidance:
My department received a hospital case of 75 members with 3,175 line items to review. My coding analyst has indicated that she has reviewed 100 line items, and so far she has found supporting documentation for those 100 line items that we payed (we are thre payor). Are there any industry standards that can guide me as to when is it appropriate to conclude the audit when it's this big and no documentation deficiencies have been identified.
We are trying to develop a policy and procedure to abide by when we face this situation. Any help, guidance and resources are greatly appreciated.
Cindy
Hello,
Seeking guidance:
My department received a hospital case of 75 members with 3,175 line items to review. My coding analyst has indicated that she has reviewed 100 line items, and so far she has found supporting documentation for those 100 line items that we payed (we are thre payor). Are there any industry standards that can guide me as to when is it appropriate to conclude the audit when it's this big and no documentation deficiencies have been identified.
We are trying to develop a policy and procedure to abide by when we face this situation. Any help, guidance and resources are greatly appreciated.
Cindy
Last edited: