Clinical audits are essential to ensure practice standards are being met by your staff and making gains toward clinical quality management improvements. Additionally, clinical audits are a large part of certification reviews by State licensing agencies and as well as the Office of Medicaid Inspector General (OMIG). Lack of practice standards in the documentation of care can lead to severe risks toward maintaining your licensure and certificate and can result in disallowances with financial risk to your organization. Get ahead of the practice curve with planned internal audits that can provide standardized scoring of current and recently closed charts. Thoughtful audit summary reports will provide recommendations for practice changes as well as highlight concerning findings. Services to provide support during and after an OMIG visit is also available to strategize on how to approach the exit audit and respond to notices of disallowances. Clinical audits are also essential with data migration from EHR implementation or module upgrades; mapping of required practice documentation is key to ensure billing accuracy as well as audit reviews for licensure and OMIG requirements.
Behavioral Health Compliance
Multiple rules and regulations exist across operational and service delivery requirements. Organizational compliance at the practice and operational levels ensure quality care and protection. The risk to not being compliant jeopardizes patient care, in terms of wellness and trust, as well as increased liability, in terms of fines and penalties. SAE provides assessments of compliancy to practice and legal standards, develops corrective action roadmaps and plans, and monitors quality improvement practices to support sustained changes. Our policy and audit expertise in mental health, addiction, and integrated care are needed assets with projects involving chart reviews, licensing acquisitions and MPHAEA.