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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 according to visit charges of doctors, medicine, stay charges, room rent, etc. Bills should be verified with the fees/charges structure.
The Commonwealth of Puerto Rico is the chief provider of health services for the indigent population, principally through the Medicaid program. The program operates within a publicly-owned and centrally administered health care delivery system which has operated under a Federal financial cap since 1968.
Audits are posited to increase accountability and improve the quality of hospital care through systematic monitoring and evaluation.
Chief compliance officers work closely with coding and finance professionals in their hospitals to prepare for the auditing process. Some hospitals conduct their own internal audits as often as every quarter but most stick to a bi-annual schedule.
Public Healthcare in Puerto Rico The public healthcare sector in Puerto Rico is generally well managed and is handled via a government-run program. No, healthcare is not free. However, the government provides insurance for those who qualify for the la Reforma, a government-funded program.
In general, Puerto Rico hospitals score lower than the national average in quality metrics, based on reports from the Centers for Medicare and Medicaid Services (CMS) Hospital Compare database1. The difference is significant in metrics related to readmission, mortality, and Emergency Department (ED) care.
Overview of Puerto Rico Healthcare SystemHealthcare is of good quality, but conditions vary throughout the island, with some areas better than others. Overall Puerto Rico has a well-rounded healthcare system. It can cater well to its citizens and visitors.
Bella Vista Hospital.Cardiovascular Center of Puerto Rico and the Caribbean.Caribbean Medical Center.Castaner General Hospital.Centro De Salud Conductual Menonita-CIMA Hospital.Doctors Center. Manati, PR 00674.Doctors' Center Hospital San Juan. San Juan, PR 00909-2518.Doctor's Center of Bayamon. Bayamon, PR 00960.More items...
Auditing Medical Records in 8 Easy StepsStep 1: Choose the Focus of Your Audit.Step 2: Define Measurement Criteria.Step 3: Determine Which Records to Review.Step 4: Decide Sample Size.Step 5: Develop Recordkeeping Tools.Step 6: Gather Data.Step 7: Summarize Your Findings.More items...?
This is a system of peer review that is led and owned by doctors and designed to assess the quality of care provided by groups of hospital-based medical specialists. Practices are surveyed every 35 years by a group of peers.