Audit Overview

The Audit Overview page serves as the central workspace for managing and reviewing an audit, providing a consolidated view of project details, audit progress, and related activities. It enables auditors and QA reviewers to efficiently access and manage all audit-related information in one place.

The page displays key details such as the Primary Auditee, Project Guideline, and Audit Guideline, along with a list of DOS entries that include patient information, status, comments, and other configurable fields. Users can customize the DOS list using the Edit Column option and access guideline documents directly from this page.

It also includes a Report Preview section that displays audit details only for completed DOS entries. The Report Preview contains multiple tabs, including Audit Summary, Key Findings and Recommendations, Audit Compliance, Checklist Accuracy, Competency Scoring, Checklist Compliance, and Data Elements, allowing users to review audit results without opening the Audit Worksheet. 

Follow these steps to access and perform actions on the Audit Overview page:

• Navigate to the Audits My Work Queue/QA Work Queue, or select View My Audits from the dashboard. The Audit Work Queue screen will be displayed.
• Select the appropriate auditee hyperlink to redirect to the desired Audit Overview page. 
• On the Audit Overview page, users can select the Audit Guideline and Project Guideline links to view or update guideline settings, based on their permissions.
  • Audit Guidelines: Audit Guidelines define the standard structure and evaluation criteria used for audits. They provide a consistent framework for conducting routine audits. Users with the required permissions can modify the guideline settings as needed.
  • Project Guidelines: Project Guidelines are derived from Audit Guidelines and can be customized to meet the requirements of a specific audit project. Users with the appropriate permissions can update the project guideline settings as required.

• The Audit Overview page includes multiple tabs that provide a high-level preview of audit results for completed DOS entries. Each tab offers insights into specific audit details, allowing users to review summarized data and navigate to individual tabs for more in-depth information. 

  📄 Learn More

  For additional details about each tab and its functionality, refer to the Report Preview article.
• The case‑level table displays all DOS entries associated with the audit. For each DOS, users can review encounter details and audit status.
• From the Action field:
  • Select a Not Started or In Progress status hyperlink to open the Audit Worksheet and perform or update audit work.

  • Select a Completed status hyperlink to review or update completed audit details.

    

• Refer to the Audit Worksheet article for detailed instructions on completing audit work.
• Repeat this process until all assigned DOS entries are finished.
• Once all DOS entries are completed, use one of the following buttons to proceed with further processing:
  • Close Send to QA: Finalizes the audit and sends it to QA for review. Refer to Close Send to QA and follow the applicable steps.
  • Close Send Report: Closes the audit and sends the final report when QA review is not required. Refer to Close Send Report and follow the applicable steps.
  • Close Pending Report: Marks the audit as pending closure, typically when additional information or review is required. Select this option and confirm to proceed with the Close Pending Report.
• Use the Edit Columns option to customize the DOS table by adding, removing, or rearranging columns.

• Use the Hide/Show Preview option to hide or display the Report Preview section as needed.

  

  Reports

  Use the Reports menu to view or print individual audit reports directly from the Report Preview section based on the configured project guideline.

  

  • View Report - Use this option to open and review the selected audit report. 

  • Print Report - Use this option to download a printable version of the selected audit report.

    

    ℹ️ Notes

    Available report options may vary depending on the project guideline configured for Professional, Dental, or Facility claims.

Edit Columns

The Edit Columns feature allows users to customize the DOS table by selecting, removing, and rearranging columns based on their workflow needs. It helps tailor the table view for better visibility and efficient audit review.

Follow these steps to access and update column settings:

• Click Edit Columns.
• The Edit Columns panel opens on the right side of the screen.
• Select the fields you want to display. Use the Search your fields box to quickly find specific columns.
• Use the drag handle next to each field to reorder columns as needed.
• Click Apply to save your changes.

Quick Options

• Select All: Displays all available columns.
• Reset to Default: Restores the default system column layout.

Closing an Audit

Once all DOS entries are completed, select Close to proceed with the appropriate next step.

Close Send to QA

Follow these steps to send the audit for QA review:

1. Complete all assigned Dates of Service (DOS).
2. Click Close Send to QA.
3. In the Assign QA popup, select the appropriate Sub-Status (if applicable).
4. Click Submit to send the audit for QA review.

Close Send Report

Follow these steps to send the report:

1. Click Close Send Report.
2. In the pop-up, select the Report Type.
3. Select the appropriate Sub-Status.
4. Click Submit to send the report.

Close Pending Report

Follow these steps to mark the audit as pending:

1. Click Close Pending Report and confirm the action.
2. Navigate to the Key Findings and Recommendations tab to review audit findings and recommended actions.