Executive summary. Open a case for the letter, let the evidence assemble from what was archived as the work happened, and answer inside the deadline.
Definition
An audit case collects a payer request and the evidence that answers it, with a deadline attached.
What to do
Open an audit case for the letter as soon as it arrives, so the deadline starts being counted rather than remembered.
The letter is resolved against what was archived when the work happened. You are not rebuilding a record after the fact; you are collecting one that already exists.
READ WHAT COULD NOT BE MATCHED. Anything the letter names that the archive cannot answer is reported explicitly rather than quietly left out. That list is your real work.
Answer inside the deadline, and record the response on the case.
Why the unmatched list matters most
A bundle that silently drops what it could not find looks complete and is not, and you would discover the gap when the payer does. Listing the unmatched items is the difference between a response you can defend and one you hope holds.
Every item that did match is drawn from the record as it was at the time, which is why it can be defended: it was not assembled to answer this letter.
Frequently asked questions
Some items could not be matched. Does that mean the response is incomplete?
It means you know exactly where it is incomplete, which is the position to be in before you answer. Those items are the ones to chase or explain in the response.
Referenced standards and further reading
- Attergo Knowledge Center ↗Attergo
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