11 Steps To Recovery Auditing
Finix can provide clients with specific data download instructions requesting specific tables from each ERP system custom tailored to each client. We don’t require a significant amount of data manipulation from the client, we prefer a full dump of the tables within the ERP system, reducing the workload on client staff. This also ensures that we are not missing any pertinent information while auditing.
Off-Site Data Work
Once the data request is received via our secure FTP site, our internal team converts the raw data into a format that is workable with our proprietary system. Once that is complete, our team uses those systems to identify prospect claim areas for further investigation while on site. This process typically takes about 1-2 weeks and does not require any investment of client time.
On-Site Kickoff Meeting
Our team will come on site and meet with the client leadership in finance, accounts payable, and procurement to better understand the business and how each client operates. Finix has developed a 30-minute group discussion process to clearly define business processes unique to the client, areas of concern for the staff, and known issues with vendors to be considered out of scope for the audit. This reduces the amount of false positive claims, and helps the auditors understand the terminology used by each client and how each term is defined by the hospital staff.
Finix auditors will begin reviewing all paper invoices for every vendor for the entire audit period. The invoice review will also identify prompt payment discounts offered by vendors and not taken by patron hospitals, duplicate payments made for the same invoice, and taxes charged to the patron hospitals that should have been exempt.
Contract To Invoice Audit
Finix can obtain guest log in access to GPO contracting databases to download price lists to electronically compare to the price paid taken from PeopleSoft or Lawson data. We are the only company with the proprietary technology to audit millions of line item transactions instantly as compared to the contract price at the time of purchase from the GPO. Once those opportunities are identified electronically, we begin reading physical contracts and validating that the contract price was in effect for the time of purchase, at which point we would generate a claim.
Electronic Data Audit
As a follow-up to the offsite data work, Finix continues to work on electronic audit techniques to identify additional recovery opportunities created within the merged data.
Finix performs an account number collection process followed by a vendor account review.
Finix provides a listing of claims identified so far in a simple to read format for discussion and approval. All claims are loaded into the customer portal where live tracking of the audit results are available to every client. Every Friday, or at an interval chosen by the client, an updated claims summary is provided to the client to track audit progress.
Recoveries From Vendors
Once claims are approved by hospital leadership, we begin our collection process with vendors. We use a soft collection process that ensures full buy-in from the hospital staff and the vendor before invoicing our customers, avoiding a “debit-and-run” model employed by legacy audit firms. Our collections team reaches out to vendor contacts, who we track in our database for easy contact, to request that they investigate a potential overpayment. A collections analyst will provide the vendor with all relevant information (spreadsheet, invoices, checks, contract, purchase orders) they require to investigate the claim. The assigned collections analyst will continue to work with the vendor to ensure a timely resolution of the claim.
Once a claim is approved and refunded by a vendor, having been previously approved by hospital staff, a check or credit memo will be requested to be sent to the hospital A/P department point of contact for the audit. Once that check has been received, Finix will invoice the client for the percentage agreed upon.
Audit Report Writing
As the collections team obtains refunds from vendors, the auditors and audit management will be actively generating the written audit report and benchmark report to present to the client. During this time, we are sourcing best practices and client examples for a written report.
Final Audit Report
Once collections activity has wrapped up, Audit Management meets with the client to present the industry-leading Profit+ Audit and Benchmarking Reports.
Finix meets with your management team and relevant employees to discuss the audit findings and recommendations as well as any further consulting opportunities to help implement solutions.