Types of Internal Audits

  • Random daily audits 2%-5% of claims processed per examiner
     
  • Performance Guarantee audits per month or quarterly reporting
     
  • New examiner audits at 100% for the first 30 days
  • New group audits which the plan document is reviewed against the system programming
     
  • High Dollar payment audits
     
  • Audits for new system implementation
     
  • Focus audits by request
     
  • Disability audits

We schedule weekly conference calls to discuss any errors detected during the previous week and we offer suggestions to help with examiner performance.

A database is provided to all clients which all audited claims are listed with the errors detected.  The database is capable to generate reports by examiner, group, location and supervisor.  Other reports are available by request.

Our clients have stated that with our internal audits their outside audits have improved due to us addressing the errors on a daily basis.

 

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Mullally Insurance Services Inc.  ◊  2665 N. Atlantic Ave, Suite 325  ◊  Daytona Beach, FL  32118
Phone: (813) 973-8700