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Next-Generation Auditing: Analytics, Bots May Change Compliance

To identify employees and vendors who could have fallen through the cracks of exclusion screening, compliance officers might periodically take a sample and run them through the HHS Office of Inspector General’s exclusion database again. This is a hit-or-miss strategy in an area with high stakes, because services provided by excluded people are not billable to federal health care programs, which is why some organizations may consider using robotic process automation instead, experts say.

Robotic process automation, which is the use of software tools as a virtual workforce, is an example of a technology used in next-generation compliance and auditing, said Landon Adkins, associate director and healthcare advanced analytics lead with Protiviti, a consulting firm.

“You can program bots to do the [exclusion] search,” Adkins said. “This is a second line of defense so you can make sure the operational process (first line of defense) is working.” Exclusion screening bots audit the entire population and pull potential exceptions in a screenshot for a compliance officer to investigate. “What is being done manually or outsourced is time intensive, but you can get in there and do all of it, not just a sample,” he said.

Next-generation compliance auditing and analytics allow compliance professionals to cover more audit ground and contribute more to strategic decisions, he said at a webinar sponsored by the Health Care Compliance Association June 25.[1]

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