Public Sector Problems – Healthcare Audits for the Public Sector

You’ve heard the word audit before. It sounds intimidating, scary, and frankly, you might not know what it entails. If you’re working within the public sector and your insurance is self-funded…here’s what you need to know.


Our short answer to this question is that we will identify more errors or opportunities for improvement than you spend on an audit, guaranteed. Every audit is different, but think about the amount of money your organization spends on healthcare every year. With an audit, you will typically find errors of 1 to 3% of your total healthcare cost. When selecting a partner to conduct your auditing, we highly recommend finding one that offers you a guarantee like CTI. Our 2 to 1 guarantee means that you’ll recover more money than the cost of an audit.

All of a sudden, this seemingly small percentage is a large amount of money, worthy of your attention and investment. Because after all, the cost of the audit will be taken care of by finding errors!


When you’re choosing who will conduct the audit for your organization, you’ll want to partner with a company that will take the time to carefully walk you through the entire auditing process, from the time frame it will take to complete the audit to the resources needed to complete it. For you, this world is heavily driven by RFPs, and while choosing the bidder with the lowest cost can be a good thing, it’s also a great idea to get a little more information about the company and the processes.


Definitely not! The term audit unfortunately has some negative connotations that might come to your mind, when in reality, most audits strengthen relationships with administrators. The goal of an audit is to fix issues and improve the relationship with the administrator going forward. That way, quality of service is improved now, and you stop the same mistake from occurring again in the future. This aspect is key to develop a constructive working relationship. We are not burning bridges, we are making them fireproof!

Although financial leaks through healthcare claims can be subtle, the money that falls through the cracks is yours!  And it adds up fast. Bottomline? An audit can save you from losing money that could better your organization. Conducting audits is a cornerstone of operating public sector organizations because it provides the opportunity for a company to step in and provide unbiased, objective assessments of whether or not the administrator is effectively achieving the desired results. And there are no hard feelings once things are found, only improved processes moving forward!

To learn more about CTI’s comprehensive healthcare audits, click on the image below for a FREE CTI resource. Or, if you’d like to talk to one of our industry-leading experts, please contact us here.


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