reimbursement

HFMA

Internal Controls

Internal Controls Function

Ø Internal control is most effective when controls are built into the entity’s infrastructure and are an essential element of the enterprise.

Ø Management is ultimately responsible for an organization’s system of internal controls.

Internal Controls Function

Focus: regulatory compliance Ø HFMA Principles and Practice Board Issue

Analysis 98-1

Internal Controls Function

Corporate Compliance Ø Failure to comply with regulations and

statutes may result in charges

Internal Control Functions

Regulations: Ø Healthcare is governed by many

regulations and standards. Ø Health information management (HIM)

department contends with many of the regulations, standards and regulatory entities.

Internal Control Functions

Regulations Ø HIM must ensure:

•  Patient information is protected from unauthorized access, safeguarded against destruction and tampering

•  The integrity of the data •  Timely access to authorized individuals •  Information is released in accordance with

governmental and organization policies and procedures (internal control system)

Internal Controls

Question: Why internal control of computerized and

other financial and patient information?

Internal Control Functions