Question

The Centers for Medicare and Medicaid Services uses a number of different methodologies to audit their services. Search "CMS audit tools." Evaluate the results. Are they what you expected?

Pick one methodology and write a 1-2 page paper on the selected methodology. Then perform a full personal audit of the tool and determine if there are any areas that could use improvement.

Answer 1

CMS will provide daily updates and a preliminary summary of results at the exit conference. The CMS audit team works efficiently to be as transparent and timely with communication to provide audit results. Medicare and Medicaid plan receive draft audit report with formal report till they receive the final report after once considering MMP comments on the draft.
Methodology:
Past performance assessment:
In each year every 14 months periods CMS clarify part C and D regulates will be updated. It includes non-compliance occurs in this period and new regulations. This helps expands their services and product types perform under this methodology. This past performance assessment at the contract level operates at any time if it is terminated. This contract includes an employer group for review. non-compliance poor performance should be documented by letter, reporting by CMS during this 14 months period.
There are performance category included in CY 2018 application review that compliance letter with plan, performance metrics with ratings, multiple Ad Hoc corrective action plans with beneficiary impact and incorrect cost sharing, failure to maintain fiscally sound operation, one-third financial audits, program audits results, exclusions, enforcement actions, Terminations and non-renewals, outstanding compliance concerns and performance actions.
The personal audit used to human resources in the organization. It reviews and assess the condition and provides solutions to increase the effectiveness of person, organization, and units. It improves the functions of the organizations. organization units important for functional specialization, geographical position, product specialization, and customer type. performance scoring important to identify the problem. communication improve organization performance and avoid denial with high negative scores.