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Leaning into a new year, as I sit to write this audit tip, I am reflecting on questions that we have been asked throughout 2022 and wondering if any of these might help everyone launch a new year with greater perspective. Well, one such question did come to mind, and it is a question we are actually asked year after year, so I am hopeful this might help.
The Fact Needed: Industry Standards for Auditing
Rationale: There must be rationale with the answer prior to giving you a reasonable answer.
Job Type: It is obvious that auditors work in all differing types of organizations. There are consulting firms, health systems, small/mid/large practices, billing companies, insurance companies, EMR vendors... and I'm sure that I am still missing many other types! With each varying position may come a different approach in skill, technique, function, responsibility, and reporting. For example, an auditor at an EMR vendor may be auditing a series of records to evaluate the use of functionality of EMR rules throughout the system, while an insurance auditor is cross analyzing tedious LCD policy to the documentation, and a consulting firm auditor may be required to research codes from two years ago due to a take back by a carrier that needs to be audit appeal that is not current year work. The role of the auditor is NOT conventional work, while the work of the coder is direct and straightforward in approach.
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