♦ I’ve had many chart audits by insurance companies and even Medicare and Medicaid. I’ve always passed with flying colors. Why do I need this?

The days of in-and-out chart audits by local auditors are almost done.  While there may be some semblance of the old-style chart-audit in the future, the reality is that data-mining and data-analytics are the way of the future.  Under the Accountable Care Act, healthcare organizations can be reviewed from the perspective of not only CMS, but also the IRS and DOL.  Federal agencies are sharing data with each other, and with commercial insurers (e.g., Blue Cross, Aetna, etc.).

The industry is being digitized at the speed of heat.  EMR’s and electronic transmission and sharing of data is now being required.  There will be exceptions, but the odds are that your organization will not qualify for an exception, so the questions are now: what will you do to comply; how much will it cost; how intrusive to your business will it be; and how quick can you get your act together to be audit-ready.

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