CMS Audit Preparation Service
For Medicare Advantage Plans (MA) and Medicare Prescription Drug Plans (PDPs)
If you've already been notified of a pending CMS audit, you likely have many questions regarding what the auditors will look for, and would like to know best practices for preparing your entire organization for CMS desk reviews and on-site audits.
With GHG’s CMS Audit Preparation Service, we’ll take your team through each step of the CMS audit process so you can prepare with confidence and ease. Our consultants assist dozens of health plans and sponsors each year to prepare for or undergo audits, giving us unmatched practical knowledgeof the regulations, regional offices and outside contractors to CMS who enforce them.
Components of GHG’s Audit Preparation Service
As part of this service, Gorman Health Group can:
- Assist with organizing and strengthening the quality of your documentation as expected by CMS.
- Provide guidance in running the CMS-required data “universes,” audit actual sample case files, and present preliminary audit findings to Senior Management.
- Audit the specific CMS-selected sample case files to provide preliminary audit findings and to identify possible risk areas. This provides the opportunity for the plan to identify and correct areas of non-compliance in advance.
- Conduct mock CMS interviews to prepare staff to effectively respond to the CMS auditors’ questions.
- Join your plan on site the week of your scheduled audit to answer questions and offer additional guidance as they arise during the CMS visit.
To learn more, we invite you to e-mail us at ghg@gormanhealthgroup.com or to call us today at 202-364-8283.
