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Question: I know audit policies are part of a comprehensive compliance program, but what should audit policies cover?

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Answer: You could think of audit policies as guidelines specifying how your organization will systemically review and evaluate health records, coding, and billing to make sure all of the documentation is accurate and compliant, said Lori Cox, MBA, CPC, CPMA, CPC-I, CEMC, CHSC, CHONC, in her presentation, 鈥淎uditing Policies,鈥� at AAPC鈥檚 AUDITCON 2024.

Make sure your policies are detailed enough to cover the specifics of what鈥檚 important for each department. Documentation needs to be comprehensive and have integrity, coding needs to be accurate, and billing needs to be compliant with payer contracts, state and federal regulations, etc.

Good auditing policies are focused policies, spelling out each process and how to strive for accuracy and adherence.

Your organization鈥檚 overall compliance plan should be much broader, covering the bigger-picture compliance areas like coding standards and billing practices, as well as following ethical obligations and legal and regulatory requirements.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Development Editor, AAPC