Even the government knows providers can’t audit themselves

June 22, 2020

The following is a column from Vachette CEO Mick Raich:

It has recently come to light that at least 10 hospitals who received HHS provider relief funds for coronavirus financial assistance have had a relationship with the firm who oversees the auditing process for how recipients spend the money, according to a recent article from Politico.

We see this often in the auditing world. When we ask about audits people say their billing company audits their claims, or that they do their own audits in-house. While I may respect the effort here, you must admit self-auditing creates a window of opportunity for lost revenue.    

Ultimately, when we do review these self-audit sites, we find their error rates to be higher than the standard industry rate of 5 percent, sometimes as high as 20 percent. So why are some groups happy to continue down this route? Partly because complacency is a common trait within most systems and humans. It is totally normal to feel secure in each situation and to avoid change. You must fight this if you want constant quality improvement and quality results. 

A professional auditor will see things most won’t. Getting outside your comfort zone and performing an audit will show you and your team what you are missing. Look at it like hiring a life coach, a personal trainer or taking lessons; working with a master improves how you view your abilities and will improve your outcomes in the long run. 

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