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ROI CalculatorBeing audit-ready indicates your preparedness for an audit by a 3rd party, either by an external auditor or a regulatory body. An organization is audit-ready if it has maintained accurate & complete records according to GAAP (or IFRS) and has complied with applicable federal regulations for its industry. Private companies may need to implement policies and procedures to establish internal controls that promote transparency and accountability.
Achieving compliance goes beyond storing documents, it entails having verifiable proof that policies are actively practiced across the business.
Document Traceability: A clearly identified document lifecycle is important to every document and consists of creating, reviewing, approving, and managing documents’ version control.
Evidence-Based Execution: Proof of execution of compliance policy must be proved by organizations, so organizations must be able to document who performed the tasks required by a policy and when they performed them and the rationale for performing those tasks to comply with the policies.
Corrective and Preventive Action: A very structured CAPA process will demonstrate to regulatory agencies that your company is effectively identifying risks and fixing problems while also reducing the likelihood that the problems will recur.
There are many downsides of undergoing an audit without suitable preparation including, but not limited to, the following:
Costly audit delays: When there is an inefficient audit process, auditors will often stop in the middle of their audit work to return to the company and establish a schedule for the company to correct its compliance problems. This will slow down issuance of financial statements and reports that adversely affects decision-making, leading to higher audit & compliance costs.
Material Weaknesses: If a firm approaches the auditing process with an attitude that "the auditors will fix it," it will face delays in completing the audits and will not have support from independent auditors in addressing those issues along with potential changes to their financial statements as there might be material weaknesses reported to the governing body and creditors.
Loss of Trust: Key executives within a firm run the risk of losing their ability to build trust or credibility with various stakeholders including but not limited to shareholders, lenders, regulatory bodies and those who hold responsibility for governance.
Inability to raise capital: In most cases, the preparation of audit reports acts as a key precondition for obtaining financing via debt or equity markets. If the process of preparing for an audit is not properly executed, potentially irreparable damage can occur to the firm’s ability to secure resources needed to fund operations and remain viable.
Provider data audits can be overwhelming. Your organization must offer all the authorizations and documents of the providers you cover. Here’s how to prepare for a successful audit:
Regular data cleansing allows an organization to proactively identify and manage issues such as duplicate/conflicting records. Even trivial errors can produce substantial negative effects on both patient care and operational efficiency.
Change tracking provides an organization with the ability to monitor and remediate inaccuracies within provider data including but not limited to provider specialties that is no longer accurate. Additionally, every level of attribute change can be tracked via a data cleansing solution such as source verification, provider attestations, and timestamps.
New regulations regarding provider information are continuously being issued to promote improved patient care and enhanced operational efficiencies. In accordance with the newly enacted Federal Consolidated Appropriations Act (CAA), health plans are required to update their provider directories within 2 business days upon receipt of any newly created or amended information pertaining to directory listing status.
Provide your staff the training and tools that enable them to adequately maintain and validate provider data. Link data quality performance metrics to staff for employees to take pride in their data quality and improve clarity in provider records.
An up-to-date provider data management program offers all the necessary tools to be prepared during an audit, including automating the recording of changes, providing complete audit trails, guaranteeing the accuracy of data, ensuring compliance with regulatory requirements in their provider records.
