Medicare Part C and Part D Program Audit Support
Advent Advisory Group is a recognized leader in helping organizations prepare for the CMS Program Audit with special focus on data integrity and universe submission validation. Advent’s CMS Program Universe Validation services allow for customizable levels of support which include evaluation of the quality, accuracy, and completeness of each program universe. We work with our clients to ensure that program universes are valid, accurately extracted, and most importantly, comply with the latest CMS guidance and protocols.
Universe Validation Services
Advent Advisory Group is a recognized leader in helping organizations prepare for the CMS Program Audit with a special focus on data integrity testing and universe submission validation. Advent’s CMS Program Universe Validation and Integrity Testing services allow for customizable levels of support which include evaluation of the quality, accuracy, and completeness of each program universe. We work with our clients to ensure that program universes are valid, accurately extracted, and most importantly, comply with the latest CMS guidance and protocols.
Partnering with Advent to have your CMS universes reviewed will provide your organization with invaluable information for your organization and compliance teams. Our process will help identify anomalies, perform timeliness testing, and most importantly, avoid potential data issues that can result in a CMS audit finding.
Advent’s team is staffed with experienced auditors with over 25 years of experience in Medicare compliance and reporting. Advent has developed proprietary tools for each of the program audit areas to identify any non-compliance at the record level. Advent’s CMS Universe Validation and Integrity Testing services assist organizations in assessing the quality, completeness, and integrity of each program audit universe under scope. Advent services are customizable to allow for the level of review that addresses your organization's needs.
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Independent Auditor (IA) Validation Services
Why you should choose Advent to validate your Corrective Action Plan
Advent is a recognized industry leader in performing Medicare compliance and CMS Program Audits nationwide, and fully meets CMS requirements for IA Validation firms. If your organization’s Medicare Advantage or Prescription Drug Plan has received a corrective action request from the Centers for Medicare and Medicaid Services (CMS), you are now required to hire an independent auditor to validate the outcomes of your Corrective Action Plan. Advent Advisory Group has the expertise to evaluate your corrections and compliance with the CMS requirement in all areas under the scope of the program audit. This includes enrollment, pharmacy benefit manager operations and management, grievances, coverage determinations, appeals, claims processing, and contract compliance.
- Our IA Validation team has extensive subject matter expertise in Medicare Part C and D as well as compliance reviews
- We have been conducting Medicare Data Validation reviews since CMS first required audited data in this area in 2011
- We have audited thousands of measure submissions for Medicare Advantage Organizations, Prescription Drug Plans, Employer Group Part D Plans, and Medicare-Medicaid Plans nationwide
- We are an NCQA-licensed Compliance Audit Organization, which attests to our data validation experience. In addition, we have a firm commitment to audit best practices and strict adherence to the highest standards of professional responsibility, codes of conduct, organizational independence, data security, and privacy
Our IA Validation team will:
- Review the CMS findings on areas of deficiencies
- Coordinate with CMS on developing an approved work plan and validation approach
- Review a records sample for each area of deficiency to ensure compliance
- Provide a validation report to CMS
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Advent Advisory Group Corporate OfficesPhone: 877.237.0190PO Box 94Northport, NY 11768
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