What is evaluated during an audit in revenue cycle management?

In revenue cycle management, audits are primarily conducted to assess compliance with regulations, identify discrepancies in billing and coding, and highlight areas for process improvements. Compliance ensures that healthcare organizations adhere to legal guidelines, such as those set by Medicare and Medicaid, as well as internal policies. Discrepancies may include errors in patient records, billing inaccuracies, or incorrect coding that can lead to revenue loss or legal penalties. Additionally, audits often reveal inefficiencies in processes that can be streamlined for better financial performance and patient care.

This comprehensive evaluation is essential for maintaining the integrity and efficiency of a healthcare organization’s revenue cycle. The other options, while relevant to healthcare, do not focus on the core objectives of a revenue cycle audit. For instance, just counting patient services does not assess financial compliance or identify operational flaws. Similarly, patient satisfaction surveys and vendor payment terms relate to patient care quality and supplier relationships, respectively, but do not encompass the broader audit goals in revenue cycle management.