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Common Monitoring Examples for a Hospital

Hospital Department

Monitoring Examples


Prior authorization (completion before appointment)

Registration errors, insurance verification (completion prior to appointment)


Insurance verification (completed during check-in)

Medicare secondary payer questionnaire

Assignment of benefits

Notice of Privacy Practices

Records Management

Number or % of orders unsigned (electronic medical record [EMR] reports)

Average lag time for cosigning verbal orders (EMR reports)

Number or % of incomplete records, types of reports, etc.

Quality management program for misfiled or commingled patient records


Coding quality management program results

Number or % of coding changes made by personnel (physician charges)

Productivity reports

Care Coordination

% of admissions seen within 24 hours of admission

% of admissions sent to physician review for medical necessity

Five physician reviews maintained as an inpatient admission

Patient Financial Services

Claims submission scrubber rejection data and trending

Denial management tracking denial codes by payer, provider, and specific segments of the revenue cycle

Payment posting adjustments due to denials

Information Technology

Access monitoring

Timely termination of employees from the system in accordance with policy

Validation of users on the system

Validation of access based on role

Staff Training

Training materials current and reflective of important regulatory updates

Pass/fail rate of training certifications

Every staff member has completed a training attestation form

Instructor quality of training


Physician transactions/arrangements

Vendor exclusion checks

Office space lease arrangements

Vendor rebates


Marketing activities to Medicare patients

Philanthropy marketing to patients and HIPAA

Patient Advocate

Incident reports or grievances related to billing, privacy, or security

Timely response to grievances

Charge Capture (any revenue-generating department)

Charging error reports sent to departments

Charging work queues

Charging errors identified or corrected by health information management

Charges without orders

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