Audit and Compliance Oversight
We serve as an experienced, trusted independent third party, partnering with contractors and agencies to ensure strict compliance with federal guidelines and policies. Our rigorous audit and oversight processes protect taxpayer resources, promote accountability, and help agencies achieve their program objectives with transparency and integrity.
OUR SERVICES
On-Site Reviews
Medical Reviews
Audit Program Development
Desk and Documentation Reviews
Data Analysis
Contractor Oversight
OUR STRATEGY FOR SUCCESS
EXPERIENCED & CERTIFIED PROFESSIONALS
Registered Nurses and Physicians
Quality Assurance Analysts
Former OIG Investigator
Subject Matter Experts
TOOLS & TECHNOLOGY
Microsoft Dynamics
RAT-STATS
Secure document sharing platforms (such as SharePoint)
PROVEN
PROCESSES
Use of protocols and checklists for all reviews
Real-time entry of findings by all reviewers
Follow generally accepted government auditing standards
OUR SUCCESS STORIES
Developing Auditing Protocols to Review Medicare Appeals Decisions
THE ISSUE
CMS needed auditing protocols to evaluate the accuracy, timeliness and quality of the Medicare appeals decisions made by the Qualified Independent Contractors (QICs).
THE RESULT
As the Evaluation & Oversight (E&O) contractor, NHA developed auditing protocols for each discrete workload and implemented a consistent auditing approach that was approved by CMS. Our development and implementation of these CMS-approved protocols have strengthened oversight of Medicare appeals, improved consistency in decision-making, and ensured that taxpayer dollars are used appropriately. When CMS later identified the need to perform similar audits on the Medicare Administrative Contractor (MAC) appeals decisions, they turned to NHA to apply our proven approach. This success led to expanded responsibilities, further demonstrating our reliability and impact in federal audit and compliance oversight.
Our Success by the Numbers
