Our customers gain accuracy while saving time and money when we apply our streamlined and efficient audit approach, which uses a data-driven automated scoping process to determine the focus of each audit.This pioneering approach has been recognized by The Centers for Medicare and Medicaid Services as a best practice.
Our audit approach has been successfully used and refined for years on Medicare cost report audits and appeals as well as other healthcare data. CSA’s scoping process is successful for narrowing down the focus for all types of compliance audits. The models compare abnormal data across multiple periods to determine areas requiring further investigation. Our knowledge of Medicare payment models has also provided our customers the needed assistance for multiple demonstration and rate setting evaluation models.
Cost Report Appeals
CSA relies on its extensive knowledge of Medicare regulations and expert analysis of complicated rules to resolve numerous cost report appeals each year. By employing a personalized approach when working with providers and healthcare consultants across the U.S., we are able to discover appropriate outcomes without creating a contentious working environment. Our results have been recognized as exceptional by the Provider Reimbursement Review Board (PRRB), CMS, and the healthcare provider community.
Our team has a proven track record of success when appeal issues have been litigated before the PRRB. CSA has more than a decade of experience in preparing detailed position papers, drafting jurisdictional challenges, executing administrative resolutions and mediating cases with providers.
CSA conducts numerous types of healthcare audits based on financial data and medical utilization data. Our customers benefit from a specialized audit team assembled based on their data and audit needs. Accountants, data analysts, clinical practitioners, and project managers can be selected to lead the audit. Our customers also benefit from customized audit plans developed to meet their unique program needs. These plans are developed by CSA’s auditors working in conjunction with the customer. Guided by identified program needs, our auditors and statisticians develop data models to target the abnormalities most likely to show findings. Auditors conduct audits based on identified targets in order to minimize the time and resources needed to complete the audit. Our clinical reviewers assist in an audit when clinical expertise is needed for medical explanations of the data.
CSA has pioneered a streamlined and efficient audit approach for Medicare cost report audits and appeals, healthcare financial data, and utilization data.
Our data-driven scoping process is used to determine the focus of each audit resulting in decreased completion time. CMS has recognized the numerous accomplishments we have achieved through our innovative audit approach.