Recalculating External Audit Results

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Recalculating External Audit Results

Postby windurstiansmn » Tue Jan 23, 2018 1:12 pm

Good morning,

I have a question regarding external audit results. We have recently contracted with a new auditing service to provide external audits for our providers. They do a great job, but the way they score E&M charts is different from our internal policy. If they find that an E&M level is off, no matter how many levels, they count it completely wrong, whereas internally we weight the score so that if it is one level off they get a 90% for that chart, two levels is a 70% and so on.

I spoke to a former manager about this issue and my concern that so many are failing because of how strictly the external auditing service is in regards to their scoring. She questioned whether changing the audit score could be considered fraud and now it has me worried. If I recalculate the results based on our method and send both scores with an explanation of what we have done, and use our score to determine auditing frequency, is that okay? Are we violating any laws that I am unaware of if we decide to do it that way? Any input would be greatly appreciated!

Thank you,

Phillip Brizendine, CPC, CPMA, CEMC
Phillip Brizendine CPC, CPMA, CEMC
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Re: Recalculating External Audit Results

Postby admin » Mon Jan 29, 2018 2:01 pm

There are no “rules” about how this should be done- other than those you create within your organizations audit policy.

When our organization provides audit services we would do the same as the company you are using- Why? Because when the OIG states a provider should have a 95% accuracy rating- they mean right or wrong, not by one level or two.

That being said, we provide audits for many organizations that do similar internal scoring mechanisms as you have, and again I am not saying yours is wrong by any means- nor am I saying theirs is wrong. You could approach this one of 2 ways:

Ask the firm to use your scoring policy. Many will honor such requests- any pushback you may experience from this is NOT due to compliance concerns- but rather it will increase their workload. This takes their team out of their “norms” and requires additional QA to ensure that everything is accurate according to your plan.
As the firm to NOT score the audit- to merely provide you with the findings, and then use your internal scoring mechanism. Once you receive their reports, while it would cause a bit more work for your team, you could then score them your way prior to distribution.

Your question has been answered by: Shannon O. DeConda, CPC, CPC-I, CEMC, CEMA, CPMA, CRTT
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Re: Recalculating External Audit Results

Postby windurstiansmn » Mon Feb 05, 2018 11:55 am

Thank you, Shannon. Your response has me reconsidering a few of our policies. While I don't think we will ever not weight the scores, perhaps we can be a bit more strict with the weighting.
Phillip Brizendine CPC, CPMA, CEMC
windurstiansmn
 
Posts: 2
Joined: Tue Jan 23, 2018 1:11 pm


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