We prepare you for audits, tune appeals and grievances timeliness controls, support RADV and documentation, and keep vendors on track. We align privacy and interoperability with practical workflows.
Key points:
- Audit readiness for CMS elements
- Appeals and grievances controls and monitoring
- RADV support and documentation uplift
- Vendor/delegation oversight and provider data accuracy
How it works:
- Baseline; CMS mapping in Build Lab.
- Field Teams run sprints for RADV, A&G, and vendor oversight.
- Quarterly Index updates and leadership briefs.
What you get:
- Audit‑ready evidence packs
- Timeliness dashboards and alerts
- RADV prep and response playbooks
- Vendor oversight files and reviews
Good fit if:
- You have audit pressure or recent findings.
- Delegated entities need tighter oversight.
- Provider data accuracy is affecting members.
FAQs
Do you sign BAAs?
Yes. We integrate training and workflows around your current systems.
Do you work with delegates and vendors?
Yes. We include them in scope and align deliverables..
Do you handle prior authorization workflows?
Yes. We assess and implement practical changes.