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Compliance audits can loom like dark clouds coming over the horizon and leave you scrambling to make sure you’re ready for them. These audits can seem like your enemy, but they can also be your friend. Like rain from the storm will help crops grow, so can compliance audits help your organization grow. Let’s break the auditing process down into bite-sized pieces so it’s less like a hurricane and more like a spring rain.

What are compliance audits? 

Compliance audits are a review of your organization’s adherence to regulations. They’re a way to make sure you are following the rules both internally and externally. Audits also ensure that any mistakes or missing pieces in your company’s processes are accounted for and set in place for improvement.

Internal audits dig into how well your company follows its own regulations and processes, and how well everyone follows or uses internal controls. This includes, but isn’t limited to, codes of conduct, employee requirements, department processes, financial controls, adherence to company policy, and if all of that supports the organization’s mission.

External audits review how well your organization complies with external contracts, laws, and requirements. This includes, but is not limited to following rules in contracted agreements with other entities, like for government funding and insurance providers, and laws such as the Anti-Kickback Statute and HIPAA.

How do they work? 

The auditing process can take weeks to months, depending on how well your organization is following the audit guidelines and how many issues the audit team is finding. Internal and external audits have similarly structured processes, but differ in purpose, guidelines, and what information is under review.

Internal Audits

Who conducts them?

Internal audits are run by employees of your organization. This can be an appointed committee of individuals from different departments or one department specifically for running audits and risks assessments. These committees or individuals are usually known as compliance officers or the internal auditing team.

Additionally, these individuals must not be in any way related to the department or area they will be reviewing, so that the process remains objective, and you can be assured the results found are accurate and unbiased.

What does the process look like?

Each organization may follow a slightly different checklist and order, but a common process for an auditor is as follows:

  1. Identify the area that needs to be audited.
  2. Decide how often the area should be audited.
  3. Make an audit calendar that breaks down what needs to be done and when.
  4. Share the calendar with the related department(s) and send alerts for upcoming checks.
  5. Follow through on the scheduled checks and communicate clearly with all involved.
  6. Following the audit, provide a copy of the final report to the department(s) in question and assist in making any necessary improvement plans.

What are the auditors looking for? 

The auditors are looking for documentation that each department is following company processes, codes of conduct, and employment regulations. they are looking for a department that both adheres to the company rules and supports its mission. The goal of the auditors is to identify risks and weaknesses in internal processes and provide plans for mitigating those risks and weaknesses before they grow into larger monsters.

External Audits

Who conducts external audits?

External audits, similar to internal audits, are conducted by a group that is not directly involved in the departments in question and is able to keep an unbiased perspective. This group can be either an external auditing company or an internal compliance team. In the case that the designated team is an internal Compliance Department, compliance officers are assigned to different areas and departments and are responsible for conducting the audit in those areas.

What does the process look like?

The auditing process is formatted to evaluate each department’s compliance with the specific regulations they come into contact with and must adhere to. Generally, external audits follow the checklist below:

  1. Meeting between the auditing group and the company’s representatives to review the whole auditing process: the guidelines for the audit, what they’re looking for, how they will be looking for those things, and how the results will be presented and finalized.
  2. Conducting employee reviews, assessing internal controls and how well they are working. determining if interactions between departments are compliant with regulations and if all documentation is up to date and accurate. (All documents and any software related to compliance are to be turned over to the auditors as they request them.)
  3. Reviewing all business processes as a whole, noting any hiccups or risks, and writing a comprehensive audit report.

The auditing team should be intimately familiar with the government regulations the organization has a responsibility to uphold as well as the guidelines for each type of audit they will be completing; review them here.

What are the auditors looking for?

The external auditors are looking for documentation that your organization is adhering to external agreements, laws, and regulations. They look to identify weaknesses and lay out a plan for patching those issues before they cause problems down the line.

Tips for success

Continuous Review and Risk Analysis

In today’s fast-paced healthcare environment, regulations are always changing quickly. The best way to ensure smooth sailing through company audits is to continuously review compliance processes and make changes as needed. Staying on top of process evaluations can help your organization avoid mistakes, keep documentation up to date, ensure employees are well-trained,  identify and resolve risks, and ultimately make the auditing process smoother. Audits are unavoidable and sudden. Continuous review of compliance processes ensures you won’t be caught off guard. \

Designate and Prepare Qualified Personnel

Set aside a designated compliance team with officers whose sole role is assessing the organization’s processes and compliance. This takes the pressure of risk management off individuals in other departments and allows the process to be handled by qualified individuals. Have an internal compliance team that is qualified, well-equipped with knowledge of regulations and auditing guidelines, and able to lead the auditing process effectively and efficiently.

Utilize Compliance Software

Continuous review and a designated compliance team can seem out of reach. Your organization may not have the time or resources to dedicate to compliance despite its importance. Many organizations have found success in utilizing a third party compliance tracking software, like MedTrainer, to keep up to date with training, credentialing, policies, and procedures.

By using MedTrainer, you can rest assured that all of your items are in one place, are updated in real-time, and easily accessible saving you time and resources. With Medtrainer your compliance management tools are curated to your healthcare organization’s size and type. You can automatically set up compliance paths for new hires and implement compliance tracking software to maintain clear objectives for all employees.

Not only is Medtrainer helpful in day-to-day compliance efforts, but also for audits themselves. All documents and any process-specific software used by your organization are under review in a compliance audit. Medtrainer allows you to have all your compliance documents in one place and easily accessible making audits that much easier. Audits are difficult to prepare for on top of the regular pace of change in all areas of compliance. With the help of MedTrainer’s compliance reporting software, your staff can focus more on seeing patients while letting our technology assist with keeping up with the many regulatory hurdles your organization faces.

If you have any questions about MedTrainer and how it can help set you up for overall compliance success, Contact Us. Looking forward to chatting with you!