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2 Company Types And Their Approach To Claim Audits: The Have To’s And The Wants To’s 

Don’t Do It Because You Have To But Because You Want To

I  am often brought in to an organization to consult on their claims auditing processes.  Whether it’s conducting file reviews for my clients, developing an audit program and procedure, or to automate the process with the Audit Portal, I have seen a lot of audits.  There are many reasons to conduct audits, but it usually comes down to one of two reasons:

  • We audit because we have to
  • We audit because we want to

The Have To’s And The Wants To’s

Companies that audit because they have to could really care less about the outcome. They audit because a regulatory agency told them they have to, an external auditor told them they have to, or senior management told them they have to. It’s a chore. Their goal: get in, get out, and figure a way to pass the review.   No one cares about the process because all it is doing is taking time away from them doing the real work at hand.

Companies that audit because they want to care about the process and the outcome. They strive to improve their organizations.  They are goal oriented and focus on improving themselves.  They do this because they understand that auditing is a way to finding gaps and making those gaps go away. It’s a way to ensure people have the direction to succeed which in turn will help the company succeed.  Companies that audit  because they want to provide better customer services,  are efficiently run, have happier employees, and are singularly focused on providing the best low cost claims services in a responsible manner.

Be The Best You Can Be

Don’t be the have to company and instead strive for excellence. Develop an audit program that encourages learning as its core value. Engage the group in the process and strive to improve both the organization and the people that make it up.  Stay focused and committed to the process and the outcome. Measure those results and track them over time. Watch how your people grow and improve, and watch your costs go down and your production goes up.

Which Company Are You?

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Posted in Best Practices, Claims Auditing.

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  1. Peter says

    My company is definitely a Have To.



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