How many medical records does the OIG recommend auditing per federal payer?

The OIG (Office of Inspector General) recommends conducting audits of 5 or more medical records per federal payer to ensure a thorough and reliable review of billing and coding practices. This number is suggested to provide a more comprehensive assessment of the healthcare entity's compliance with federal regulations and the accuracy of claims submissions. Auditing a larger sample size allows for better detection of patterns or issues that could indicate systemic problems, thereby facilitating more effective compliance management and risk mitigation within healthcare organizations.

By examining at least 5 records, auditors can get a clearer picture of compliance trends, helping to identify potential areas for improvement. This approach ensures that the audit findings are statistically significant and provides a better foundation for corrective action if necessary.