What type of audit is performed on one provider?

A focused audit is conducted with a specific scope, often aimed at a single provider or a particular aspect of care. In the context of auditing, it targets certain areas of concern, such as coding practices, billing accuracy, documentation compliance, or specific clinical services rendered by that provider. This type of audit allows the auditor to delve deeply into the operations and performance of an individual provider, assessing their adherence to established guidelines and identifying any issues that warrant attention.

Focused audits are beneficial for enhancing quality control, pinpointing provider-specific errors, and promoting best practices within that individual’s practices. It contrasts with a comprehensive audit, which assesses broader practices across multiple providers, and a random audit that looks at a wide but unspecified sample of providers or claims over a period. The initial audit typically refers to the first audit conducted for an organization or provider to establish a baseline and identify areas for improvement, but it does not specifically refer to a single provider approach as a focused audit does. Thus, when auditing a single provider, a focused audit is the most appropriate methodology.