11/12/2025
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NEW program at The Alliance Training Center
Strategies for Senior Managers to Evaluate the Accuracy and Timing of Data to Reduce Regulatory Payment and Compliance Risks
Senior leadership and Administrators must focus on the importance of data accuracy, timing requirements and substantiating documentation. The number and type of audits is increasing as well as the frequency of requests for documentation prior to and after claims payment. This interactive fast paced session will explore CMS audit programs as well as the new Data Validation process initiated 10-1-25. The structure of targeted internal audits and documentation reviews are essential for Operations, Clinical and Financial Managers to monitor data formulation processes. Specific examples of audit tools, documentation, review interviews and MDS -RAI Manual definitions will be discussed. This session guides the managers to target areas that will identify data issues that can be resolved so compliance status and payment levels are not impacted. Reference and audit formats will be presented. Operational leadership must be aware of the various types of internal analytics the MACs and CMS use to identify payment patterns and data that impacts compliance or identifies problems in the data reporting and documentation process. Internal targeted audits which are usually not complicated can signal issues related to accuracy, operational efficiency (transmissions and submissions) or need for training on coding instructions. Examples of simple, direct, consistent, targeted data reviews will be demonstrated. A must do session for Senior Managers, Regional Consultants, Operational and Clinical Professionals, MDS Nurses, Therapists and IDT Members.
Objectives:
1) Identify audit activity that can be replicated by management to identify functional and procedural problems.
2) Review types of audit activity CMS, MACs and O.I.G. are supporting as well as the Q.R.P. Validation Process.
3) Discuss impact of pro-active internal audits to reduce payment and regulatory risk.
4) Discuss formats and reporting methods for audits to improve data quality and reproducibility of the data base.
5) Demonstrate the audit process, documents and reports to provide data and specific interventions to correct data and improve accuracy
When: December 4, 2025 - 9:00 a.m. – 4:30 p.m.
Cost: $125 per person
Instructor: Leah Klusch, RN, BSN, FACHCA
NAB approval #20261203-6-A117314-IN for 6 hours
Call us to register and pay! (330) 821-7616
The Alliance Training Center
103 E. State St. Alliance, Oh 44601
www.tatci.com
