Thrive Revenue Cycle

Audit Defense Playbook – Proactive Tools to Prepare, Respond, and Defend

💲 Price: $1,200 flat fee

A comprehensive toolkit designed to help RCM leaders, compliance officers, and provider groups proactively prepare for payer audits and confidently respond when they occur. This playbook transforms reactive panic into strategic readiness by equipping your team with proven audit defense assets.

📦 What’s Included:

  1. Audit Readiness Checklist
    • Facility-wide self-assessment to identify vulnerabilities before an audit
    • Covers documentation, coding, billing, compliance, and appeal readiness
  2. Payer Audit Tracker Template
    • Excel + Google Sheets formats
    • Log and monitor audit requests, response deadlines, outcomes, and appeals
  3. Response Packet Templates
    • Pre-formatted cover letters, document indexes, and submission packets
    • Tailored formats for RAC, MAC, UPIC, ZPIC, and commercial payers
  4. Common Audit Scenarios & Defense Tactics
    • Top 10 reasons for audits and how to respond
    • Includes sample language for medical necessity defenses, bundling disputes, and modifier usage
  5. Escalation Protocols
    • Step-by-step framework for appealing unfavorable audit determinations
    • Contact escalation scripts for payer representatives and independent reviewers
  6. Education Materials for Staff
    • One-pagers for front desk, clinicians, and billers on audit risk triggers
    • Quick-reference HIPAA-compliant documentation tips
  7. Compliance Integration Map
    • Links audit defense to internal policies, procedures, and training logs
    • Helps you meet CMS and payer documentation retention requirements

🏥 Ideal Use Case:

  • RCM or compliance teams anticipating increased audit volume
  • Practices preparing for Medicare TPE, CERT, or commercial prepay reviews
  • Health systems implementing annual compliance programs
Arm Your Teamk

Prevent losses. Respond strategically. Build your audit wall before they knock.