“How are other companies doing that?” Over the years, this is the most frequent question we hear from our health plan clients. It became clear that there was a need to create a forum for claim audit, benefit/provider contract configuration and cost containment representatives to share insights, benchmarks and challenges on common topics of interest.

Datamethod hosts a free Audit Webinar Series to address that need… to give you a place to hear what others in like positions are doing – how they are managing their QA work – to build a forum for an open exchange of ideas covering ‘all things audit’.

Below are upcoming webinar topics that are scheduled, including a brief description of the goals for each session and access for event registration.

There are no upcoming events at this time.

Previous Webinar event topics:

October 11, 2018: “Auditing Adjustments”

  • On average, 3% to 5% of claims posted are adjustments to an original claim.
  • 70% of adjusted claims are positive – paying more to the provider.
  • Nearly twice as many errors are found in adjusted claims than the original claim processed.

November 15, 2018: “Audit the Auditor”

  • Only 50% of health plans perform ATA audits on a routine, scheduled basis.
  • 25% to 50% of auditors select incorrect or inconsistent Error Categories for classification

Listed below are the session topics we have scheduled for 2019. We’d love to have your input and ideas on additional topics of interest. Please feel free to contact us and enter suggestions or sign up to receive updates as new webinars are released to the schedule.

  • Error Category Selections – 25% to 50% of Error Classifications are Wrong
  • Integrating Recovery with Audit – Error Logged… But Did You Get the Money Back?
  • Audit Scope – What are You Auditing… and Why?
  • Auditing Provider Configuration – What to Test… and How to Manage the Process?
  • Claims Auditing – Should You be Looking at More than Claims?
  • Error Identification vs. Error Avoidance
  • Audit Selection – Random Sampling vs. Stratification – What’s the Impact?
  • Corrective Action and Remediation Management
  • Provider Contract / Fee Schedule Audits – 50% of Your Errors are Hidden Here
  • Focused (or Targeted) Audits – Adding Value to your Production Audit Results
  • Prepayment Audits – High Dollar Claims… and Other Valuable Insights
  • CMS – Developing Best Practice Audits for Medicare / Medicare Advantage Programs

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