How to Build a Hospital Audit Plan

This checklist distills the top takeaways from our recent webinar on hospital audit planning, offering practical steps and expert insights to help your team build a stronger, more strategic audit program.  

1. Develop a Policy for Formal Risk Assessment and Audit Planning

• • Ensure your hospital has a written policy requiring a formal, routine risk assessment. 

• • Use the results of that assessment to define and update your annual audit plan. 

• • Align with OIG and DOJ guidance on how to prioritize high-risk areas. 

2. Identify Sources to Flag Potential Audit Issues

• • Review internal risk assessments, HIPAA assessments, and quality data. 

• • Monitor external data sources like the OIG Work Plan, MAC TPE audits, RAC issue lists, and state-specific Medicaid reviews. 

• • Don’t forget internal triggers—billing anomalies, complaints, or changes in services. 

3. Collaborate Cross-Functionally to Build the Plan

• • Include input from finance, revenue cycle, IT, quality, privacy, and clinical leadership. 

• • Host planning sessions that align operational insights with compliance risk priorities. 

• • Involve legal or internal audit to ensure independence when appropriate. 

4. Secure Approvals and Allocate Resources

• • Present your audit plan to the compliance committee or board for approval. 

• • Ensure adequate staff, budget, and external support where needed. 

• • Build timelines that align with internal reporting deadlines (e.g., board reports). 

Pro Tip: Come prepared with data. Tie each audit area to risk assessments, revenue impact, or regulatory requirements to clearly justify its inclusion and priority. 

5. Build in Flexibility for Unplanned Risks

• • Leave “slack” in your schedule to accommodate investigations, complaints, or new service lines. 

• • Periodically reassess your plan against emerging risks. 

6. Measure and Report Progress Against the Plan

• • Track which audits are complete, in progress, or delayed. 

• • Flag audits that identify overpayments, require corrective actions, or need re-review. 

• • Report outcomes to senior leadership and board members. 

Pro Tip: Audit Manager+ helps you track audits every step of the way, with a quick-view dashboard to see progress at-a-glance. 

Looking to Take the Next Step? Talk to a Specialist about Healthicity’s Solutions: 

Compliance Manager 
Centralize risk data, streamline collaboration, and align with OIG and DOJ guidance while keeping leadership in the loop with customizable dashboard reporting. 

Audit Manager+ 
Audit Manager+ helps you execute, track, and report audits with ease. Stay organized, flag issues, and adjust quickly when new risks arise, all from one powerful platform.

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