Streamlined process delivers quality results in compressed timeframe for 2013 audits
MILWAUKEE, Dec. 21, 2012 /PRNewswire/ — PSRx Advisors announced the launch of its high-efficiency data validation audit, available in 2013 for CMS Medicare Parts C and D data validation of data reported in 2012. Under the high-efficiency model, auditors conduct virtual onsite visits via teleconferences and webinars at the plan and the Pharmacy Benefit Manager (PBM). These take the place of physical onsite visits, saving staff time and resources. Preliminary audit results for each measure are delivered within three weeks of receipt of required data for that measure.
The streamlined process provides cost-saving efficiencies for health plans, and builds on the foundation PSRx Advisors has developed for performing Medicare Parts C and D data validation audits for numerous clients since the data validation audit program began. The virtual onsite visit is scheduled on or after April 1, 2013, per the CMS-required audit timeframe. Audit clients utilize PSRx’s secure client experience portal to upload data and documentation, check the progress of the audit, and keep up to date with the latest CMS reporting requirements and regulations.
Robert Shelley, President of PSRx Advisors, commented: “Our streamlined process is a natural progression in our Parts C and D data validation audit process. As we enter the third year of data validation auditing, we found that many plans have received high scores on most measures in past data validations and are able to readily provide the required data.” He continued, “Our highly experienced audit team conducts a virtual onsite via teleconference and webinar to review the information that has been received and cover the few areas for which data cannot be provided through secure transmission, such as certain source code.”
In guidance released October 24, 2012,1 CMS clarified that if a health plan uses a contractor for data validation consulting or pre-assessment, the plan may not use that contractor to perform data validation auditing for three years from the date of the consulting engagement. As a result, a number of health plans have determined that they need to contract with a new audit firm for the data validation audit. According to Shelley, “Some health plans that had contracted with a data validation audit firm are now scrambling to find another contractor if their prior firm also performed consulting for them. Our high-efficiency audit fills the void. Most plans are able to realize significant cost savings as well. We also provide a web-based project management tool that enhances the client experience and adds to our efficient process.”
When it’s time to find a new Medicare data validation auditor, plans need to look no further than PSRx Advisors. PSRx Advisors’ high-efficiency audit process gives plans confidence that they have received a thorough validation of 100% of their data – and gives their staff valuable time to spend on other projects.
About PSRx Advisors
PSRx Advisors is a leading provider of Medicare Part C and Part D data validation pre-assessments and audits. Led by industry experts in Medicare Part C and Part D operations, the PSRx Advisors audit team works with plans to ensure its audit services meet CMS requirements and exceed plans’ expectations for thoroughness, accuracy and fairness. Each member of the audit team is a Medicare subject matter expert who has been conducting Medicare data validation audits since the inception of the program. The team includes Certified NCQA HEDIS Compliance Audit™2 auditors as well as experts in pharmacy data systems, compliance, reporting, bid submission, and more.
1CMS PowerPoint Presentation, “Part C and D Data Validation,” October 24, 2012
2HEDIS Compliance AuditTM is a trademark of the National Committee for Quality Assurance (NCQA).
For further information about PSRx Advisors’ high-efficiency data validation audits for Medicare Parts C and D, contact Kristin Karakis, PSRx Advisors Marketing Manager, at 414.302.9733 Ext. 245, or E-mail Kristin at Email.
Kristin Karakis, Marketing and Sales Manager
Ph.: 414.302.9733 Ext. 245