Managing the highly regulated areas of Medicare Parts C and D can be a daunting challenge for health plans. Factor in a CMS audit, and the complexity and associated administrative burden can skyrocket.
On today’s program, Change Healthcare Consulting’s Phillip Cardona, Melissa Bailey, and Tim Gundlach explain CMS audit universes; managing the considerable amount of data they can require; and best practices for preparing for and facilitating the audit process.
Here’s what they reviewed:
- CMS and the role of “audit universes” (00:34)
- What audit universes mean to health plans (01:55)
- Audit universes defined and how they’re changing next year (04:18)
- Recommendations for providing “clean” universes to facilitate the audit process (09:39)
- Best practices for ensuring accurate data sources (11:43)
- Preparing for the data validation webinars with auditors (13:13)
- The need for periodic monitoring (14:32)
- How a Medicare audit tool can help reduce the administrative burden (16:25)
- Phillip Cardona’s bio
- Melissa Bailey’s bio
- Tim Gundlach’s bio
- Consulting Resource Center
- Change Healthcare Consulting Services
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