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PHO audit information

Karo has prepared the following summary of what your PHO can expect when the MoH does its scheduled PHO audit of patient eligibilty and practice enrolment processes. It is based on the PHO Audit Protocol which is available on the MoH website: Primary Health Care Audit Protocol

 

When the MoH audits a practice, they randomly select a statistically significant number of patients. They examine these patients' enrolment records and calculate the amount claimed for ineligible patients. Based on these findings, they work out the financial penalty for the entire practice and PHO. The following section explains how this policy of extrapolation is carried out.

 

Please note: This tool is currently unavailable as at 01/03/2019. We aim to design another option for this once NES is fully implemented in the sector.

 

Karo has developed an invaluable tool to enable PHOs to easily assess both their own and their practices' financial risk from a Ministry of Health PHO audit. The tool is a 'dummy audit' that assesses a sample of enrolment forms from each practice, finds the errors and calculates the potential financial penalties across the whole practice and PHO.