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Scenario Red Flag – Audit Procedure Assessment
Procedure:
Description:
Detail:
Path:
Provider Compliance - Submission of Accurate Claims and Information > Billing - Patient not present > Billing for services not provided - Using phantom or deceased persons' names > Patient File Does Not Agree with Billing Records
Assessment
Red Flags Audit Assessment
(
edit
)
1.
Audit Work Performed
Yes
No
2.
Auditor
3.
Audit Work and Results
Findings
No Findings
4.
Red Flag Frequency
Frequent
Moderate
Infrequent
5.
Red Flag Risk
High
Moderate
Low
Audit Findings
Add Finding...
Finding
Type
Residual Risk
Test Finding
Compliance Red Flag
Moderate
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|
delete
Detail
detail finding statement
Residual Risk
some residual risk
Management Response
Management response goes here
Add Finding...
Audit Test Evaluation
Test
Test Description
Red Flags Frequency
Red Flags Risk
Risk Narrative
Test patient files
Test
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