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At least 379 records · Page 21Linked to original sources
PubMed2005

Assessing the financial effect of Medicare payment on rural hospitals: does the source of data change the results?

In this policy brief, we explore how predictions of changes in hospital financial performance as a result of change in Medicare payment differ when comparing results using data from the Medicare Cost Report (MCR) to results using data from the audited hospital financial statement (FS). The purpose of this exploratory research is to test the assumption that MCR data yield a valid indicator of changes in hospital financial well-being.

Data Collection↗
PubMed2002

Using the OIG model compliance programs to fight fraud.

Many healthcare organizations already have implemented compliance programs for their facilities. However, in light of recent fines and continued scrutiny of such programs by the HHS Office of Inspector General (OIG), healthcare organizations should consider reviewing their current programs against the OIG's relevant model compliance program. Although healthcare organizations are not required to adhere strictly to OIG's model programs, they would benefit from ensuring that their programs meet all the OIG's requirements. The common, minimum elements suggested by the OIG model programs include development and distribution of written compliance policies, the designation of a chief compliance officer to manage the program, the development of a corrective action and enforcement system, and the use of audits to monitor compliance. Using these models as guides, healthcare organizations should be better able to avoid the possibility of fraud and abuse within their organizations.

Financial Audit↗
PubMed1988

Fresh terrain for medical record practitioners.

This article describes hospital bill audits and their purpose, what information is needed, when and where the audits are carried out, and the roles medical record practitioners can perform in this process.

Accounting↗
PubMed2002

What CFOs should know--and do--about corporate responsibility.

Not-for-profit healthcare organizations are not immune to the scrutiny arising from corporate accounting scandals and legislation. Financial managers will play a critical role in satisfying corporate-responsibility concerns. Financial managers need to understand the public-policy concerns fueling the corporate-responsibility movement and the effects. Financial managers should take steps related to certifying financial statements, establishing audit committees, and ensuring independence of audits, among other actions.

Financial Audit↗
PubMed2003

Tactics for thwarting silent PPO activity.

Silent payers can be difficult to detect, and their payment practices can drastically affect a hospital's bottom line. An audit approach to payment problems can uncover silent PPO activity. Information from the audit can be used to negotiate a settlement for the unpaid amount. Contracts with payers should include specific language that protects against silent PPO activity.

Contracts↗
PubMed1991

Direct purchase contracts carry risks, benefits.

To better control their purchasing of healthcare services, some employers are seeking direct managed care contracts with healthcare facilities. Along with evaluating potential markets introduced by a proposed contract, a provider should develop a pricing strategy, a monitoring system, and a process for internal audit before entering into a direct purchase contract. With the proper checks in place, direct purchase contracts can be mutually beneficial to providers and purchasers.

Contract Services↗
PubMed1993

Hospital characteristics: can an audit be predicted?

Each year Medicare-participant hospitals submit a cost report to the Health Care Financing Administration (HCFA) to settle their reimbursement claims. These reports are subject to audit, and a decision by HCFA to audit can be costly to the auditee. This article uses data from 6,270 cost reports filed in 1986 to explore the factors related to the probability of an audit. Logistic regression equations are estimated to examine how hospital characteristics influence the chance of audit. The results suggest that audit probability can be predicted with reasonable accuracy by a hospital's bed size, ownership type, teaching status, function, proportion of Medicare inpatient days, and geographic location.

Data Collection↗
PubMed1989

Turn losses into gains: the bad debt audit.

The post-bad debt audit is the ideal time to review the policies and procedures that affect patient accounts. Review the Hill-Burton procedures if appropriate; review the manner in which accounts are processed for public assistance or welfare. Investigate unconfirmed third-party coverage and other areas of potential slippage. The bad debt audit is an excellent management tool to gain insight into the entire patient accounting processing cycle. It is an extremely efficient and cost-effective resource if properly conducted and if recommendations for improvement are properly implemented and monitored.

Accounting↗
PubMed1998

Applying new AICPA accounting rules on special reports.

Two new standards on agreed-upon procedures, issued by the American Institute of Certified Public Accountants, provide healthcare organizations and associated decision makers with new flexibility in acquiring professional accounting services. Effective January 1, 1996, these procedures allow organizations to target the type and volume of services performed by accountants and potentially avoid the time and expense involved in completing a full financial statement audit. As with any other accounting engagement, both the healthcare organization and the accounting firm need to establish what procedures will be conducted, who will be allowed to use the resulting report, and how the procedures will be conducted.

Accounting↗
PubMed1992

Who's knocking at the door? The IRS issues new audit guidelines.

The IRS is arming its agents with a detailed blueprint for exemption audits and has announced that it is stepping up the number of examinations it will undertake. A spokesman for the IRS recently announced that the service is not actively seeking to revoke exemptions. However, this statement offers only partial comfort. Merely increasing audit activity and the depth of the examinations will mean more time and expense for hospital administrators regardless of the outcome. The moral of this story is clear: Things will get tougher when the IRS auditor knocks on your door, and the likelihood of that knock has increased. As I stated in my previous Trustee article (see Health Law, p.10, January issue), hospital trustees and administrators need to get their houses in order. Your hospital should be imposing these audit guidelines on itself before an IRS examining agent does it for you. My earlier article sets forth specific suggestions in this regard. Recent developments--including the new IRS guidelines--only emphasize the importance of preparing for the IRS.

Community-Institutional Relations↗