Getting prepared for a CMS UM-Focused Audit?    Need help with post-audit corrective action?

Given the new, deeper scrutiny from CMS, Medicare Advantage plans can rely on ATTAC’s experienced compliance team to: Test application of UM criteria through review of denials and evaluate whether they're consistent with NCDs/LCDs Review plan and FDR denial letters to ensure they're transparent about reason/basis for denial; we’ll provide guidance on meeting CMS’s expectations Review criteria used by UM committees, including ensuring they're well-structured and coverage criteria are transparent/accessible Prepare your medical directors/staff by collaborating with our senior clinical advisor, a physician expert in utilization management Test downstream delegates to ensure they’re fully compliant with plan rules and criteria Perform a UM-focused mock audit that mirrors CMS’s approach, including review of FDRs Help your plan refine denial language and member communications to ensure compliance Determine if communications from IPAs follow plan rules and criteria Evaluate your plan’s data universes against latest CMS protocols Contact us to take control of your UM-focused audit with support from ATTAC's Medicare Advantage and Part D compliance experts.

Learn more about our UM-focused audit capabilities here

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