What is Provider Audit™?

Provider Audit

The Provider Audit™ is an easy-to-use solution to assess risks and provides a rapid audit of the reasonableness and fair market value risks of individual and large groups of physicians. Whether performing regular compliance reviews or conducting due diligence as part of an acquisition, the Provider Audit™ streamlines the identification of risky or outlier arrangements by assessing compensation, productivity, and other payment data. The Provider Audit™ reduces the valuation process from days to minutes, and cuts costs from thousands of dollars to hundreds. It is available to both health organizations as well as law firms and is aimed to elevate compliance and enhance legal service value.

The tool was developed with General Counsels and Compliance officers who want to “check the temp” of Physician compensation for an organization:
• Merger
• Acquisition
• Implementation of FMV Policy and Procedure

The tool assists in ranking arrangements by risk level.
Those Risk Levels are:
Low – There is low Fair Market Value Risk, but the physician may need updates to their compensation.
Moderate – This is what is expected for the Market and there is low risk.
Above Market Value Range – ​The result indicates there could be Fair Market Value risk associated with this provider. Carnahan Group recommends an extended analysis be performed to ensure the provider is not being paid outside of Fair Market Value.

Provider Audit™ comes with many benefits:
• Organizations can demonstrate they are conducting due diligence even if there is not an FMV report accompanying each Physician’s arrangement.
• Audit will enable you to take immediate action on high-risk arrangements.
• Organizations can focus their resources on arrangements instead of doing a massive FMV initiative.

The Provider Audit™ is part of the FMV-MD™ platform. This overall FMV tool is an unrivaled software with modules that instantly analyze simple and complex physician compensation arrangements alike, determining clinical, medical director, on-call, administrative, and academic compensation for fair market value and commercial reasonableness.

Visit FMV-MD™ to learn more about this platform and how it can help your organization or practice.