Why should audit findings be discussed with the provider audited?

Why should audit findings be discussed with the provider audited?

• A. To identify where the provider has committed fraudulent activities before providing the information to the OIG.
• B. To provide a risk analysis, identify problem areas, and recommend corrective action with supporting documentation.
• C. To become friends with the provider so he will hire you as an auditor resource again.
• D. To identify abuse areas before providing the information to Medicare.

Answer: (B)

Discussing audit findings with the provider being audited is about transparency and collaborative remediation. It allows the auditor to frame a risk analysis, pinpoint problem areas, and, with the provider’s input, develop corrective actions and gather supporting documentation. This helps ensure the findings are accurate, complete, and actionable, and it gives the provider a chance to explain context, supply missing records, and commit to improvements before the final report is issued. The aim is not to pre-emptively flag fraud or abuse to other authorities or to build relationships for its own sake, but to produce a solid, defensible plan for addressing risk and preventing recurrence.

Discussing audit findings with the provider being audited is about transparency and collaborative remediation. It allows the auditor to frame a risk analysis, pinpoint problem areas, and, with the provider’s input, develop corrective actions and gather supporting documentation. This helps ensure the findings are accurate, complete, and actionable, and it gives the provider a chance to explain context, supply missing records, and commit to improvements before the final report is issued. The aim is not to pre-emptively flag fraud or abuse to other authorities or to build relationships for its own sake, but to produce a solid, defensible plan for addressing risk and preventing recurrence.