In auditing, what is the purpose of reviewing a patient's medical record?

Reviewing a patient's medical record serves a crucial role in ensuring compliance with healthcare standards and identifying potential risks. This process involves analyzing documentation to verify that the care provided meets established clinical guidelines, regulatory requirements, and payment standards.

By thoroughly evaluating the medical record, auditors can assess whether the documentation supports the diagnoses and procedures billed, thereby preventing improper billing practices and potential fraud. Furthermore, this review helps in identifying any gaps in care or areas where medical practice could be improved, contributing to overall patient safety and quality of care.

Engaging in this process allows healthcare providers to maintain accountability and improve internal policies to align with best practices, ultimately enhancing patient outcomes and the organization's integrity within the healthcare system.