When the audit reveals an error or non-conformance, what must be identified and cited?

When the audit reveals an error or non-conformance, what must be identified and cited?

• A. The specific reason for the non-conformance must be identified with citations to the applicable policy provision or binding rule.
• B. Only the amount of the overpayment needs to be identified.
• C. The provider's own opinion should be cited.
• D. The date of the audit should be cited.

Answer: (A)

When an audit reveals an error or non-conformance, you must identify the exact reason for the non-conformance and tie it to the applicable policy provision or binding rule. This creates a clear, defensible basis for the finding: it shows precisely which rule was violated and how the audit finding connects to that rule. Citing the specific policy or rule guides corrective actions, supports any required recoupment decisions, and provides an auditable trail for follow-up. The amount of an overpayment alone doesn’t explain why it happened, the provider’s own opinion isn’t a neutral basis for judgment, and the audit date addresses metadata rather than the underlying issue.

When an audit reveals an error or non-conformance, you must identify the exact reason for the non-conformance and tie it to the applicable policy provision or binding rule. This creates a clear, defensible basis for the finding: it shows precisely which rule was violated and how the audit finding connects to that rule. Citing the specific policy or rule guides corrective actions, supports any required recoupment decisions, and provides an auditable trail for follow-up. The amount of an overpayment alone doesn’t explain why it happened, the provider’s own opinion isn’t a neutral basis for judgment, and the audit date addresses metadata rather than the underlying issue.