Your Audit Response Partner
You open your mailbox and see an inauspicious letter from your biggest insurance funder. You open it and start reading … and your hands begin to tremble. The words are daggers, cutting into your integrity: “Inconsistent billing.” “Incomplete documentation.” “Recoup money.” “One week deadline.” You know you’ve done everything with the right intentions and you know the children you serve have life-changing outcomes. Fighting audits isn’t what you signed up for.
Insurance audits can be terrifying. You feel like your reputation is at stake. We get it. We’ll walk with you every step of the way: first to successfully navigate the audit… second to help you build robust compliance systems so you’re ready for any audit. That’s what it means to rest easier at night.
“We don’t learn from experience. We learn from reflecting on experience.”
Audit Response Team process
- Clarify audit requirements: align understanding with insurance company; request extension
- Internal forensics: review contracts, gather documentation, interview team
- External review: legal, accrediting body, regulatory agencies
- Risk & mitigation assessment: identify gaps, quantify at-risk revenue, determine financing requirements
- Audit Response: official follow-up with insurance company
- Post-mortem: reflect, learn, improve
Are You Looking to Build Compliance Infrastructure Before Your Next Audit?
Element is here for you. We’re your partner in developing robust compliance solutions. These are custom tailored to your needs and can include:
- Mock audits: revenue cycle risk assessment and mitigation plan
- Learning and training: pre-mortems and after-action methodologies to embed learning into your organizational DNA
- Formal leadership designation: Chief Compliance/Privacy/HIPAA Officer job descriptions and on-going responsibilities
- Payer concentration analysis: how exposed are you if one (or more) of your payers slashes reimbursement rates or alters service provision terms?
- Quality of earnings prep: if you’re looking for outside investment
And much more. Partner with us so you can focus on what you do best.
We strongly encourage autism providers to consider accreditation. 3rd party validation of your commitment to continuous improvement can set you apart to prospective clients, employees and payers.
There are several accrediting bodies in the autism care, mental health and medical field
Note: Element does not endorse any specific accrediting body; reference on this page is for educational purposes only and does not imply a contractual relationship between Element and the accrediting bodies.