Appeals Toolkit: Turn Healthcare Insurance Denials Into Dollars
Brian W. Kozik
Manual & CD-ROM Resource Kit
11" x 8.5"
HCPro / Opus
(click the button below for the very best currently available price for this important resource)
Your organization's success is measured by many standards. None is more important than the integrity and accuracy of data. That's why your job as an auditor is so critical.
Auditing and compliance professionals are under significant pressure to demonstrate—at any given moment—that their organization is in step with the myriad rules and regulations from their state, OIG compliance guidance standards, U.S. Sentencing Guidelines, and the Sarbanes-Oxley Act, as well as the good business practices your organization has developed over time.
Maintaining an effective auditing program is the only way to ensure compliance with all of these expectations.
The Healthcare Auditor's Handbook, this book and CD-ROM resource, will help you develop a logical audit process and follow it from beginning to end. This comprehensive, one-stop training package that will help you:
develop an audit plan and determine scope and depth
choose a sample and gather appropriate documentation
focus the audit to a specific target area
conduct interviews and observations to supplement audit data
organize findings and craft recommendations
develop an audit report and present it to the executive committee or board of directors
implement corrective action
schedule a follow-up audit to ensure compliance with initial findings
assess when to bring in an expert to conduct the audit
It's loaded with tools you'll use every day. The Healthcare Auditor's Handbook includes tools and forms you can use immediately to strengthen your auditing program. You'll find the forms on the accompanying CD-ROM, so you can easily download them, customize them, and start using them right away. You have to conduct audits. Make sure you use the right tool.
To ignore auditing—a critical component of your compliance program—is to take unnecessary chances. The Healthcare Auditor's Handbook is an essential partner in your auditing success, whether you work in a hospital, physician practice, clinic, long-term care facility, or ambulatory surgery center. Take a look at the Table of Contents:
Applying the OIG's government auditing standards
The elements of an audit finding
Performing risk assessments
Tips for supporting an audit finding
OIG sampling techniques
Gather appropriate documentation
Planning and executing an audit
How to write an audit report
Monitoring for fraud and abuse
Brian W. Kozik is director of compliance and audit services for the North Shore Medical Center in Salem, MA. He is responsible for overseeing the medical center’s comprehensive compliance program for Salem Hospital, North Shore Children’s Hospital, Union Hospital, Shaughnessy-Kaplan Rehabilitation Hospital, and Charter Professional Services Corporation. He has more than 20 years’ experience in the internal audit, process-improvement field, and five years of experience in healthcare compliance. Brian is an active member of the Health Care Compliance Association, the Society of Corporate Compliance and Ethics, the New England Healthcare Auditors Association, and the Institute of Internal Auditors Association.
With more than 17 years of experience, HCPro, Inc. is a leading provider of integrated information, education, training, and consulting products and services in the vital areas of healthcare regulation and compliance. The company's mission is to meet the specialized informational, advisory, and educational needs of the healthcare industry. As an acknowledged industry authority in healthcare regulation and compliance, HCPro focuses on providing its clients assistance and expertise in the areas of accreditation, medical staff affairs, credentialing, privileging, medical record management, regulatory compliance, nursing, quality/patient safety, infection control, and workplace safety.
(information from the publisher)
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