Audit Failures and Penalties from Lab Documentation Gaps

$10,000-$25,000 in potential audit citations; 20-30% of standing orders found non-compliant during random Medicare audits • $10,000-$30,000 in Medicaid recoupments for unsupported standing orders; potential program exclusion risk • $10,000–$25,000 annually from disputed charges, patient refunds, and regulatory fines due to missing consent/result documentation

Compliance officer creates manual pivot tables in Excel comparing order dates to patient diagnoses; uses VLOOKUP formulas to match standing orders to current clinical status • Compliance officer maintains separate workers comp order log in Google Sheets; cross-references claim numbers manually with lab results; prints requisitions and files in separate physical cabinets • Compliance officer maintains Tricare-specific folder on network drive with scanned physician order forms; manual calendar reminders for annual standing order reviews