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

1. Phillip Cardona's bio
2. Melissa Bailey's bio
3. Tim Gundlach's bio
4. Consulting Resource Center
5. 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