Healthcare audits play a significant role in uplifting the service quality for patients and providers and aid healthcare organizations to be in line with compliance and regulations. When healthcare audits are in play, it’s pretty evident that it
- Improves the patient experience
- Improves the quality of care
- Reduce cost to some extent,
- Avoid unwanted redundancies.
From the recent reports, it’s been evident that quality auditing is essential for all the stakeholders involved – Patients, Providers, and Payers.
Here are the different types of healthcare audits and the perks they bring to revenue cycle management (RCM).
The random audit is the most commonly used healthcare auditing process, which involves having a fundamental insight into the organization and its functions. The random audit is done on an ad-hoc basis, without a particular timing or subject. They just investigate whether claims match the relevant date and time per the original data.
Random audits give a clear idea of whether deep auditing, like a systematic approach, is required to help the providers with the problems that need to be addressed.
Unlike a random audit, a comprehensive audit follows a systematic and streamlined approach to documentation with an eye for detail involved in every step.
The comprehensive audit ensures that the claims are processed without any disputes as it involves a step-by-step approach. This is mainly suitable for organizations requiring a solution for disagreement on a specific type of claim or asking for a refund.
The hybrid audit is a mixture of both random and comprehensive audits. In the hybrid audit, the auditors simultaneously conduct inspections for random and comprehensive samples. This auditing type provides deeper insights into the claims and filters the errors missed during random or comprehensive audits.
The hybrid audit offers a roadmap for the claims and has a futuristic approach.
Quality Improvement Audit
Quality improvement audit includes strategies, and the focus is on both patients and providers simultaneously.
Medical information from several patients and different conditions is collected and analyzed right from the inception until each one is solved. During a quality improvement audit, the auditor keenly analyzes every step – the quality of care provided, patient satisfaction, financial cost, etc. – thereby addressing the problems and achieving the desired result.
As a result, a quality improvement audit offers more significant insights for providers on improving their services and delivering the best healthcare possible.
Summing it up:
Not many healthcare providers have incorporated healthcare audits in their portfolio, and now it’s high time for the providers to enhance their operations, making it hassle-free for both them and their patients. Don’t know where to start? We are here to help while you can take care of your patients. For details, please visit https://www.rannsolve.com/.