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Look to outside experts as another line in your defense against fraud and theft, suggests Dawn Q. McLane, RN, MSA, CNOR, executive director of Allied Physicians Surgery Center in South Bend, IN. Specialists with expertise in accounting, pharmacy operations, radiology, and medical records can conduct periodic audits to make sure that proper procedures are followed and that there are no discrepancies that might indicate foul play, she says.
Although most people think of an audit as the right thing to do at the year end to review financial statements, smaller quarterly audits of specific items might be more effective to uncover fraud or theft, says Ronald L. Ralph, CPA, a partner in the health care services group of Crowe, Chizek, and Co., a South Bend, IN-based accounting firm that does business, public sector, and information technology consulting.
"At the annual audit we see the overall picture, but we don’t see details," he explains. Quarterly audits might include testing 100 fee tickets by tracking the tickets through billing, payment, and posting, he says.
There are several ways to find qualified consultants who do specialize in health care, says McLane. "Looking through professional magazines for ads, talking to people at conferences, and general networking are the best ways," she says. "Remember, however, to check references and talk to prior and current clients before hiring someone."
You can use professional organizations such as the Federated Ambulatory Surgery Association (FASA) in Alexandria, VA, to obtain names of consultants who do have expertise in same-day surgery, suggests Ralph.
To obtain names of consultants, contact:
• Federated Ambulatory Surgery Association, 700 N. Fairfax St., Suite 306, Alexandria, VA 22314. Telephone: (703) 836-8808. Fax: (703) 549-0976. E-mail: FASA@fasa.org.