As health plans attempt to measure the acuity of new patients through the Affordable Care Act’s healthcare marketplace exchange, hospital audit teams will see a huge influx of commercial risk ...

Here’s a quick breakdown of formal and informal audits: Audit (formal) – the annual ritual of providing objective evidence that a quality system is established, followed and effective. A good quality ...

Because Medicare and Medicaid claims audit requests can look like routine billing-related correspondence, they can be easy to miss, leading to expensive and potentially catastrophic consequences.

Internal audits are conducted in accordance with the Global Internal Auditing Standards as promulgated by the Institute of Internal Auditors (IIA). Other auditing standards may be followed as deemed ...

As such, organizations are making their vendors obtain System and Organization Controls (SOC) attestation reports, as mandated by SSAE 16 and SSAE 18. A SOC report is a verifiable auditing report ...