Automated data integrity auditing system

A method of calculating the potential impact of data integrity problems on reimbursement, where the reimbursement is based for each individual on a vector of items from a single assessment, comprising the steps of:

• for each individual assessment and each data integrity issue involving reimbursement-related items, determining how that data integrity issue could be resolved by revising a single item response;
• determining the smallest such change in favor of the payer that would resolve each data integrity issue of an individual assessment in the order that the data integrity issues are listed in the audit system such that no data integrity issues remain to produce an amended data vector that has no data integrity issues and favors the payer;
• determining the smallest such change in favor of the organization that would resolve each data integrity issue of an individual assessment in the order that the data integrity issues are listed in the audit system such that no data integrity issues remain to produce an amended data vector that has no data integrity issues and favors the organization;
• and
• calculating reimbursement based on the validity of the original data vector.

A method for assisting facilities in the completion and submission of required regulatory data, comprising the steps of:

• checking data provided by the facility for proper coding and completeness in accordance with regulatory requirements;
• storing the data in a computer database together with indicators specifying bad data found during said checking step;
• and
• processing the stored data to:
• apply one or more data integrity tests to a portion of data stored in said database that does not have any bad data specified by an indicator;
• assign a score to the portion of data based on the data integrity test;
• and
• generate and provide to the facility, in real-time, a report that identifies said score together with suggestions for resolving any data validity problems located by said data integrity test;
• whereby the facility is able to revise the data in response to said real-time report prior to submission to the regulatory facility.

A computer program for assisting facilities in the completion and submission of required regulatory data, said computer program comprising routines for:

• checking data provided by the facility for proper coding and completeness in accordance with regulatory requirements;
• appending indicators to said data, said indicators specifying bad data found during said checking step;
• processing said data to apply one or more data integrity tests to a portion thereof that does not have any bad data specified by an indicator;
• assigning a score to the portion of data based on the data integrity test;
• generating a report that identifies said score together with suggestions for resolving any data validity problems located by said data integrity test;
• and
• providing said report to the facility on a real-time basis;
• whereby the facility is able to revise the data in response to said real-time report prior to submission to the regulatory facility.