For example, the documentation may not meet the level billed due to missing one element of the review of systems ROS , but the defense may be that the services were performed and were medically necessary. Whereas, with the physician, you would focus on education to change future behavior e. Some protection may be provided by auditing under attorney-client privilege. This requires an attorney-client relationship, with the auditor acting in coordination with the attorney, and the client communicating in confidence with the attorney for secure legal advice.
The report should identify what was included in the audit, as well as what was not included. This will help you understand the scope of the audit.
For example, know whether all payers were reviewed or if the audit is a judgment sample or a statistically-valid random sample. A judgment sample cannot be extrapolated; whereas, a random sample may be.
Extrapolation occurs when assumptions are made about the results. For example: An audit shows 40 percent of reviews for Evaluation and Management code were over-coded.
Under the Health Information Technology for Economic and Clinical Health Act, overpayments must be refunded within 60 days of the date of discovery to avoid further penalties under the False Claims Act. The report should specify the locations, clinics, and providers that were reviewed, as well as whether the audit was conducted onsite or remotely.
Know how the audit was performed. Here is a statement that is appropriate when reporting the audit. The following audit parameters were followed:. The why should be specifically stated to provide context and suggest response.
Consider and answer the following questions when crafting a narrative report or executive summary, such as the one shown in Figure A. The executive summary should include a high-level overview of the issues and how they are being addressed, the expectations, and any action plans, detailing necessary education. Be sure education plans specify who needs it and who will provide it.
The level of detail provided will vary depending on who you report to. For example, the provider will likely want to see encounter-level detail, while administration will just want to see broad results. The compliance department will want to see every detail, while the attorney may want only want detail of an overpayment that must be refunded.
CLA specializes in Physician Practices and outpatient and inpatient hospitals She has more than 28 years of experience in healthcare and medical records management, coding, auditing and compliance in the hospital, outpatient, and physician settings.
Giangreco Brown is a member of the Greeley, Colo. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise.
Earn CEUs and the respect of your peers. Knowledge Center. Hot Topics Toggle navigation. Print Post. Answer six questions to provide a concise audit that is purposeful, corrective, and educational. To be sure your intended message is received, consider these six questions when preparing your audit report: Who are you reporting to?
What are you reporting? When was the audit performed and what date range did it cover? Where was the audit focused? How was the audit performed? Who Are You Reporting To? Other questions to consider: Is compensation affected by these results? Will the provider be more interested in the percentage accuracy as an audit score or the net dollars involved?
Does the organization have coding policies that the provider has no control over? What Are You Reporting? When Was the Audit Performed? Where Was the Audit Focused? This contains a statement on either the company created its financial report correctly or not. The requirements for audit depend on the following;.
Audit report has impact on the perceived value of any audit financial statement. During issuing audit report, the auditors should be highly careful because a number of people depend on these reports to make their decisions. However, the basis audit report should contain the following components;. After that, the auditor can issue the report. Mention the basis on which you had obtained the reported opinion.
Also, include the facts of your basis in order to make it more credible. These are the most basic components that should be included in your audit report. You can also include additional information that is relevant to the document. Moreover, this is best of all the types of audit reports that any company may receive. After the title, there is the main body of the report that consists of three paragraphs. In these paragraphs, you have to highlight the following;.
Creating this type of document is identical to creating an unqualified opinion. However, the main difference is that it contains an additional paragraph which demonstrates the reason why the auditor deemed the audit report as qualified. This is the worst type of report a company receives by an auditor. After receiving such type of report, you should correct all of your financial statements and then have them re-audited.
Auditors are not able to accomplish an accurate report in rare cases. This occurs for different situations such as an absence of the required financial records. In conclusion, an audit report template is an effective tool for businesses that includes the results of the whole audit process.
An audit report is considered as a type of appraisal required to complete financial status. Audits are conducted for different reasons such as for acquiring funding, complying with government standards, etc. Vote count:. No votes so far! Be the first to rate this post. Table of Contents Why do you require an audit report?
Components of an audit report: Opinions of audit report: Unqualified opinion: Qualified opinion: Adverse opinion: Disclaimer of opinion: Conclusion:. Download Template 63 KB.
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