Medicare Advantage: Making Sense of the Audit Universe
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) Episode Resources Phillip Cardona's bio Melissa Bailey's bio Tim Gundlach's bio Consulting Resource Center Change Healthcare Consulting Services Show Resources SUBSCRIBE to the podcast using any podcatcher or RSS reader Download the audio and listen offline Get the iOS app Get the Android app Suggest or become a guest Contact Change Healthcare
