Best Practices to Prepare for a Compliance Audit

Perspectives from a Compliance Officer and a Consultant

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Compliance programs — a necessity for all health care providers — must continuously improve based on changing regulatory requirements, government enforcement activities, the evolution of health care and changing organizational structures. A particularly challenging area for health care organizations is government and regulatory agency audits.

In this webinar, we will review examples of different types of government audits (Medicare/Medicaid billing; HIPAA Privacy) and how to prepare for these reviews. These audit preparation strategies are useful for any hospital or provider compliance program, whether you have received notification of an upcoming audit or you want to proactively leverage these best practices to mitigate and minimize risk.  

Leaders from auditing and advisory firm Deloitte & Touche will discuss how to prepare for audits based on their experiences as a former chief compliance officer and as consultants for many clients. They will share ideas on how to structure your audit, types of documents and information that needs to be included, individuals and departments who may play a key role in the audit process and how to use the audit results to improve your program and reduce your compliance risk.

What You Will Learn:

  • Steps to take in preparing for government and regulatory audits  
  • Benefits of conducting a mock audit
  • How to use audit results to make improvements in your compliance program

Partner(s):

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Thought Leaders

Julie Hamilton
Managing Director
Deloitte & Touche
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+Bio

Julie is a Managing Director within Deloitte Advisory’s Life Science and Healthcare practice.  Julie has over 25 years of experience in the healthcare industry specializing in developing, assessing and managing corporate compliance and education programs.  Julie has over 11 years of experience serving as Chief Compliance Officer at academic health care systems, most recently as the Vice President, Chief Compliance Officer at Yale New Haven Health.  In this role, she was responsible for system wide compliance program development and oversight which included extensive collaboration and engagement with executive leaders as well as the Board.  She was the owner and Managing Partner of a healthcare compliance consulting business for four (4) years.  As a consultant, she worked with hospitals, physician offices and other healthcare organizations in the Northeast and Midwest including DME, SNF, and Indian Health centers providing compliance program assessments, effectiveness reviews, policy and procedure review and development, audits and education.    

This experience has given Julie a thorough understanding of healthcare operations, enterprise risk assessment and mitigation, and compliance program development and implementation particularly within merger and acquisition due diligence, hospital and physician documentation, coding and billing matters, conflicts of interest, research compliance, hospital-physician financial arrangements, and pharmacy billing.  She is particularly interested in assisting compliance programs in assessing their effectiveness as well as modernization efforts.  

Julie has an MBA from Creighton University and is certified in healthcare compliance (CHC) and as a Fellow of the American College of Healthcare Executives (FACHE).

Kelly Sauders
Partner
Deloitte & Touche
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+Bio

Kelly is a Partner with Deloitte & Touche LLP who has over 20 years of experience in the health care industry.  She specializes in providing regulatory compliance and risk services  in the health care industry. Kelly has led  numerous regulatory compliance program assessments, HIPAA/privacy program assessments, implementation projects and responses to government investigations.  Many of these have involved documentation, coding or billing matters.  This experience includes coding and billing for hospitals, physician groups, skilled nursing facilities, home health and hospice. She has also been involved in many enterprise-wide risk assessment  and ERM program development projects.  In these roles she works frequently with boards of directors and executive teams.  

This experience has given Kelly both a broad and deep understanding of  health  care (e.g. academic and community hospitals, physician/clinic, SNF/HH, outpatient, etc.) and the impact of changing regulations not  only on health care organizations but on large employers and companies in related industries. Kelly has also served several academic medical center and health system clients as an interim chief compliance officer and as an interim director of internal audit .  She has assisted numerous clients with CIA-readiness, government investigations , OIG audits, and self-disclosures regarding documentation, coding and billing matters and has led a number of Independent Review Organization (IRO) engagements.  Kelly has also served as an expert witness on a billing dispute between a medical practice and a hospital. She is a frequent national speaker on compliance programs, ERM, coding and billing matters, internal controls and other regulatory topics.

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