decisionhealth Newsletters, Part B News - 2025 Issue 11 (November)
Audits are coming: Prepare with an audit response plan
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Article Overview
This compliance-focused article is for medical practice leaders, coders, compliance staff, and revenue integrity teams who need to prepare for audit requests and additional documentation requests. It covers how to establish an audit response workflow, who should handle incoming requests, how to read and assemble supporting records, and how to track submission and follow-up activities without missing deadlines.
Why This Topic Matters
Audit response problems can turn otherwise well-documented claims into denials or other adverse outcomes if requests are missed, incomplete, or poorly organized. A clear internal process helps practices respond consistently, protect documentation integrity, and reduce the risk of avoidable audit failure.
Article Sections
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Compliance
Introduces the audit-preparedness theme and emphasizes the importance of having a response process in place before requests arrive.
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Don’t be scared. Be prepared.
Discusses how practices should assign responsibility for audit response and build internal readiness across departments.
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Ready, set, read the ADR
Focuses on reviewing audit requests carefully and understanding the information they contain so that the response can be complete and timely.
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Tell the story when you assemble the packet
Covers general organization and submission practices for assembling supporting records and documenting the response process.
What You Will Learn
- How to establish an internal audit response plan
- How audit response responsibilities may be assigned within a practice
- How to review audit requests for completeness and timing
- How to organize supporting records before submission
- How to document and track the audit response process
Who Should Read This
- Medical practice administrators
- Compliance staff
- Coders
- Revenue cycle teams
- Billing managers
- Practice leaders
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