Experience the benefits of AuditWell
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Control
Tightly manage your audit programs. View work end-to-end.
Productivity
Increase auditor productivity 20% to 50%
Findings
Do more. Realize the benefit of the errors and findings you manage.
Flexibility
Customize workflow, data, error communications, and more.
I have 213 auditors and I can see, in real-time, what they’re doing.
I have three goals for my audit team this year – and AuditWell allows us to easily track each one.
We consolidated legacy systems claim feeds into one set of audits in AuditWell.
My audit team never waits for screens or pages to load.
AuditWell gives every auditor real-time dashboards to manage work, aging and productivity.
In AuditWell, we can move or reassign audits to other staff in less than a minute.
I come in on Monday morning and all our audit files are sampled – audit cases are automatically delivered to the correct auditor to work.
25 years of making auditing easier
AuditWell supports large and small audit teams with an enterprise platform to manage audit workflows.
5 clicks
5 clicks
Time it takes an Auditor to load a new error or finding
3 minutes
3 minutes
Number of minutes to load a new audit with 1,000 transactions.
99.8 percent
99.8 percent
SLA for application uptime
1 step
1 step
to move work from one auditor to another
Why are you auditing?
Audits support and optimize company operations. Organizations conduct a variety of audits or quality assessments to meet state and federal regulatory requirements, manage service and compliance, and control quality.
Let’s talk about some common types of audits:
Examples of regulated audits include:
- State Medicaid audit requirements
- State insurance audit requirements
- Claim payment or other process timeliness audits
- CMS program audits or internal mock audits for testing
- Internal audits required by the company compliance department
- Claim appeal or grievance audits
- Government or industry-related quality audits
All businesses conduct audits on internal operational business systems and processes like:
- Billing statement audits
- Membership / ID card issuance audits
- Inquiry / IVR / Service communication audits
- Policy / contract fulfillment audits
- Audit of EOBs or plan communications
- Underwriting Analysts
- Provider or contract payment configuration audits
- System configuration audits
- System vs. source documentation audits
- Overall business process quality audits
Most businesses typically conduct internal staff quality and performance monitoring audits for work involving:
- Customer Service Representatives
- Claims Processing Analysts
- System Configuration Analysts
- Membership or Billing Analysts
- Provider or network contract analysts
- Appeals and Utilization Management Department staff
Businesses occasionally have negotiated service performance commitments with specific clients – known as performance guarantees. To manage and report this monitoring they conduct audits like:
- Customer Service representative accuracy
- Customer Service call timeliness
- Claims payment accuracy
- Claims payment turnaround time
- ID Card issuance audits
- Inquiry / IVR audits for timeliness and accuracy
Clients monitor certain work activity before it is released to the production environment – or payment is generated:
- Pre-payment audit of claims
- Pre-payment audit of high dollar or focused provider transactions
- Pre-release audit of utilization review, underwriting or appeal transactions
- Updates / changes to benefit or payment configuration settings
- Audit of migration transactions from one legacy system to a new platform
How are you auditing?
67% using Excel or spreadsheet tools
18% using an in-house developed database tool
15% using email combined with other applications
Spreadsheet auditing
Our clients tell us that they previously used a variety of approaches for managing audits. Most of the time their audit work lived in Excel or some sort of spreadsheet tool. Unwieldy and limiting – especially for large, diverse audit teams.
Home-grown audit tool
Other clients built their own in-house database audit applications, solving the problem when first built. However, ongoing time and support from IT to maintain the tool was challenging. Eventual loss of control and the unresponsive tools just couldn’t meet demand for changing audit needs.
Email-managed auditing
Some clients were using their email inboxes to manage audit work – as an adjunct to spreadsheet tasks. Audit delays, missed information, and cumbersome management were just a few of the common complaints.