Score High with Polished Policies – Win the Favor of CMS Auditors

Is your Medicare Advantage health plan still in the early-to-mid stages of building a Special Investigations Unit (SIU)? Are you struggling to write program policies and procedures (P&Ps), or do you fear your current ones may be slightly under-developed? Perhaps you have no existing policies at all? Don’t fret! Let the compliance professionals at Segal Medicare Experts (SME) do the heavy lifting for you!

If you are among those who find the technical writing of Medicare Advantage P&Ps to be a daunting, mentally grueling task – you’re not alone! Contact us today to discuss how we may assist with your P&Ps. or 562.334.7980

SME can craft a tailored set of fraud-related policies for your health plan simply by virtually meeting with you one-on-one, and listening to a verbal “walk-through” of your current process and P&Ps. A subject matter expert will then gather the necessary components to thoroughly review the specifics of how your current program is run, and will organize them accordingly. If there appear to be any procedural gaps missing, Segal Medicare Experts will ensure to include the required information in the final set of written policies.

Finally, SME will compile, edit and finalize a polished collection of FWA policies specifically custom-built for you. Additionally, if you want assistance processing your FWA cases, we at SME would be happy to roll up our sleeves and work them with you.

An FWA program that exhibits well-defined, organized policies, and can demonstrate an ability to abide by these established policies is sure to stand-out as an exemplary Medicare Advantage Organization in the eyes of CMS, and will impress most CMS auditors! All in the process of helping to fight FWA.

All inquiries are welcome. or 562.334.7980