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WellSpan Health in York, Pennsylvania, developed this policy and procedure to make sure everyone at its eight hospitals and other entities are on the same page with respect to outside auditors and consultants, says Sue Shollenberger, director of corporate compliance for WellSpan Health-East. Also, “if we have someone do an external audit in one system, it’s nice to share the outcome or findings across the system so we get the most bang for our buck,” she says. That’s unlikely if departments hire auditors on their own, without observing the procedure. Shollenberger added that it’s designed to prevent the rare occasion when a biller responded to a Medicare auditor’s request for documentation instead of forwarding it to compliance. Contact her at sshollenberger@wellspan.org.
PURPOSE
To guide WellSpan Health employees in addressing review/audit results from “external entities” and externally hired consultants/auditors that focus on rules and regulations, including, but not limited to, documentation, billing, coding guidelines, and other rules or regulations governing healthcare services (i.e., OSHA, Human Resources, etc.).
