Initiation & Close of the Audit


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Please let me know ASAP if it is too complicated!! Using the hypothetical medical practice detailed for the final project (Attached), develop an audit program to be used for a standard baseline audit. The baseline audit assumes you do not have any prior historical data on the level of compliance in this practice and need to review a random sample of all services provided and for which bills were sent to the carrier. Use the Resources and Templates (attached) as well. Using the audit templates provided, customize for your own purposes or develop new templates of your choosing. You can also conduct further research to find additional examples/templates. These templates will be provided to a team of auditor/coders who will use them in the field work to document findings. This should include a brief department policy and procedure that include types of audits that will be conducted, schedule of routine audits, what the sampling methodology will be, identification of who will pull the cases and how the field work is to be completed, and follow-up and refunding procedures. Your deliverables will be the following (Clearly Identify Each Deliverable): 1. A brief Policy & Procedure for the Assignment, Initiation & Close of the Audit (Assignment, Initiation, and Close of Audit must all be addressed in the P&P). Be sure this is in proper format for a policy and procedure. Look for examples on the Internet if you are not sure what these look like. 2. How you will determine a sample size and sampling methodology (define this within the P&P) 3. Who will pull the cases and how the field work is to be completed (define this within the P&P) 4. Outline of the resulting report (you do not need to write a report – an outline of the sections is what is required) – Separate Report 5. Sample entrance and follow-up letters – Separate Attachments (one example of each!)

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