What Hospitals Need to Know About Clinical Validation, POA, and HCC Audits

As healthcare audits become more data-driven and precise, ensuring your hospital’s documentation can stand up to scrutiny is essential. Our webinar spotlights three audit types every compliance and coding team should master: Clinical Validation Audits, POA Indicator Audits, and HCC Audits. 

Clinical Validation Audits are designed to verify that documented diagnoses are supported by the patient’s clinical picture—think vitals, labs, and treatment decisions. A diagnosis alone isn’t enough. Auditors need to see evidence that supports it. 

Present on Admission (POA) Indicator Audits affect both compliance and reimbursement. Misreporting a POA status can lead to inaccurate quality metrics and potential penalties. Understanding when and how to accurately apply POA indicators is critical, especially as value-based care continues to gain traction. 

Hierarchical Condition Category (HCC) Audits are primarily focused on outpatient settings and risk adjustment. Chronic conditions like diabetes, CHF, or COPD need to be correctly documented and coded each year to ensure accurate risk scoring and appropriate funding. 

Together, these audit types represent high-impact checkpoints for both clinical documentation improvement and revenue integrity in hospitals. If you're looking for more content developed for hospital teams, check out our recent webinar on Building a Hospital Audit Plan, available on-demand.