Applicant eligibility determination is a complicated process. With so many important factors to weigh from intake to the final decision, and so many people applying for the same benefits, there is already a superabundance of information to consider before having to take applicant or patient into account. Unfortunately, the risk of waste, fraud and abuse occurs in many industries and is a a major obstacle in regulated industries such as insurance, healthcare and telecommunications.
Third-party program integrity auditing, or enlisting the help of an outside agency to complete your audit review, is the solution to this problem. This type of auditing is is available to your organization when you decide that the time is right to outsource your eligibility determination. Here are some ways that Solix, a outsourcing services company, can protect your company and the public benefit programs that so many depend on:
- You can count on certified fraud examiners.
Let a third-party panel with professional expertise as well as compliance controls ensure that no fraudulent activity makes its way into your program. Our experts are trained to monitor applicants and sort out areas of program risk for those who are abusing the system.
- You can focus your resources on other important programs
When you outsource program integrity audits, you can free up your resources for other important aspects of your program and take advantage of a more flexible, scalable model. Since the program is designed around your criteria and risk tolerance, you can audit certain stages of your program or the entire process and be confident you meet compliance standards.
- Never guess again about the health of your program.
Outsourcing eligibility determination provides more than just a onetime audit. It is an active, holistic step towards the elimination of waste, fraud and abuse. Trust in the ongoing reports from monitors who keep a careful eye on your program to ensure compliance and honesty.