This session will focus on key aspects of what is involved with detailed claims testing in a health and welfare plan environment. This session will be especially helpful for those auditors who do not have an in-house claims testing expert available to deploy to test the adjudication of claims to help support the audit opinion of a health and welfare plan. Documentation best practices will also be discussed, including data retention and other important HIPAA considerations.
Reconstruct an understanding regarding what is involved in the detailed testing of health and welfare claims when an in-house claims testing expert is not available
Assess best practices for handling PII and PHI during a health and welfare plan claims audit.