A Compliance Audit Checklist For Healthcare

Medical coding audits are an integral component of operating an efficient healthcare organization. They identify compliance issues, offer educational opportunities and help drive decisions within the health system.

HIPAA compliance is of utmost importance for organizations that use patient PHI data. Unfortunately, there’s no one-size-fits-all set of rules pertaining to HIPAA. With this HIPAA Compliance Checklist you will better understand which guidelines pertain to your organization.

1. Conduct an Internal Audit
Healthcare compliance audit tools are crucial to upholding legal and regulatory standards within the industry, while protecting healthcare organizations against financial risks.

An internal audit is an examination of company practices to ensure they comply with established rules. An internal audit can often help identify areas for improvement; however, this type of examination may also be conducted for other reasons.

Realist reviews have recently shown that externally initiated audits increase QI awareness but are less effective than bottom-up initiatives. Healthcare professionals tend to engage more readily when an audit is led by someone they view as their champion and seen as learning opportunity rather than exam tool; and more likely share knowledge with colleagues as part of sharing learning experience.

2. Conduct an External Audit
Healthcare facilities must comply with applicable compliance regulations in order to avoid fines and financial repercussions. Conducting regular internal audits can help your hospital identify failures, risks and issues that must be addressed quickly in order to enhance operations and increase profits.

Compliance counsel from outside will often perform a comprehensive analysis of your hospital’s compliance program to ensure they are adhering to all state and federal laws and regulations. Their deep knowledge of healthcare laws will allow them to quickly spot any violations that arise in compliance monitoring processes.

Recent realist reviews revealed that externally motivated audits can foster quality improvement awareness; provided healthcare workers view them as learning experiences and are encouraged to provide feedback directly to leadership positions.

3. Conduct a Security Audit
Healthcare organizations must protect the private information of their clients at all times. Data breaches can cause serious financial implications for practices and businesses alike; to keep their data safe, healthcare companies should conduct regular security audits.

Audits help businesses pinpoint security loopholes, create policies to mitigate vulnerabilities and detect breaches before they impact business operations. They also serve to track compliance guidelines adherence as well as monitor how confidential information is managed by business associates.

Preparing well is key when conducting either an internal system evaluation or formal compliance audit like SOC 2, so utilizing an integrated work execution platform like Smartsheet to streamline processes and store all necessary documents efficiently for audits.

4. Conduct a Privacy Audit
Healthcare industries must abide by rigorous standards to protect patient records and confidential data, and regularly perform compliance audits to assess internal processes as well as external rules and regulations.

Compliance audits assess an organization’s adherence to government regulations, industry standards and their own policies. This process involves reviewing internal structures and systems such as corporate governance (e.g. corporate policies, registration paperwork, appointments/elections of organizational officers) as well as physical safeguards and employee privacy training programs.

An HIPAA compliance audit is an integral step in assessing how secure patient data is within your company, with violations leading to costly fines for practices and erosion of patients’ trust. Smartsheet makes HIPAA auditing processes more effective by consolidating all critical information in one central repository and streamlining reporting processes with greater visibility for greater audit transparency.

5. Conduct a Breach Notification Audit
Compliance auditing is the practice of reviewing a business’s compliance with industry regulations and standards to identify any gaps or areas where its adherence must be tightened up. Typically, auditing involves gathering documents, cross-referencing regulations against regulations, and developing an efficient timeline for when the audit will commence and end.

An HIPAA breach notification audit is an integral part of healthcare organizations’ compliance programs, ensuring that safeguards exist to protect patient data.

Ultimately, this assessment will identify any unexpected issues that could be contributing factors in breaches, including “Category B” errors associated with infection control – such as colonoscope reprocessing without disinfectant solutions or for less than the recommended duration.