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State of California Health and Human Services Agency Department of Health Services Audits and Investigations MEDICAL SUPPLEMENTAL COST REPORT SCHEDULES Hospital Name Fiscal Year End DHS 3092 (12/05).
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Xix FAQ
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An Auditor should check the bill book, bill register and copy of bills. It should be verified that bills are prepared properly ing to visit charges of doctors, medicine, stay charges, room rent, etc. Bills should be verified with the fees/charges structure.
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Medi-Cal is jointly administered by the Centers for Medicare and Medicaid Services (CMS) and the California Department of Health Care Services (DHCS), while the county welfare department in each of the 58 counties is responsible for local administration of the Medi-Cal program.
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Medical Audits and Corrective Action Plans DHCS' Managed Care Quality and Monitoring Division (MCQMD) is responsible for ensuring overall monitoring and oversight of MCPs. MCQMD designates the Contract & Enrollment Review Division (CERD) of DHCS' Audits and Investigations (A&I) to perform the mandated audits.
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Clinical audit is a quality improvement process that was introduced to the NHS by the 1989 White Paper Working for Patients. Previously known as medical audit until a name change in the early 1990's, clinical audit involves reviewing the delivery of healthcare to ensure that best practice is being carried out.
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The random audit is the most commonly used healthcare auditing process, which involves having a fundamental insight into the organization and its functions. The random audit is done on an ad-hoc basis, without a particular timing or subject.
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