Internal Monitoring and Auditing: Element 4

Written by: Sam Jones

One of the ways you can see if your program is effective or not is by taking a pulse of the impact it has throughout your organization. This is why having systems and processes in place for auditing is essential. Your organization may already have some aspects of this in place through the policies and procedures such as, how someone reports an issue and where that issue is cataloged within the system; who oversees these reports; who inputs them into a database, and keeps them on file if ever needed for an external audit or any investigations.

Surveys are a great tool to use for taking the compliance pulse of the organization. When you survey your organization, you are getting a real-time snapshot of where your compliance program’s effectiveness currently stands. These surveys can be a yearly or even twice-yearly opportunity to check-in and track progress. When you are surveying regularly, you can use the results to inform your compliance program decisions, and communicate to employees the importance of their input. Auditing and monitoring allow you to use the data to identify areas for improvement, assess success in messaging, and use the information in meaningful reports to the board.

When setting up your auditing and monitoring systems, look at every tool within your organization, including your payment system, patient portals, business associate agreements, employee eligibility status and any other step in the patient care procedure. By examining each of these aspects, you can tailor your auditing and monitoring efforts to suit the needs of each area. Some of them need to be looked at on a weekly basis, others may only be once a year. Take time to map out the frequency needed for each area.

Often, when we work “in the trenches” of the compliance program every day, it can be easy to overlook certain things that have become normalized. It can be very beneficial to have a new set of eyes walk through the program, so to speak, and see the things we are missing.  Having an outside consulting conduct a program effectiveness review is not only a good way to energize the compliance program, but it is also an expectation by the government. We all need fresh eyes to get a new perspective, and to ensure the auditing and monitoring tools of the organization are helping us build and maintain the most effective compliance program possible.

Most business leaders get frustrated when employees don’t do the right thing.  You shouldn’t have to convince people to do what is right.  MCA builds a compliance program and a culture where employees do the right thing, the right way, at the right time so you can focus on taking care of the people you serve.

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Midwest Compliance Associates

(319) 553-0258