Schedule Audit

1
ICE Shared Credentialing Scheduling Audit
Process
Schedule Audit
5. According to internal policies, each HP sends
letters to Provider Organizations confirming
audit dates and confirmation to post
1. Participating Health Plans (HPs) share a
listing of contracted Provider Organizations
6. Once posting letter has been signed, the
letter is sent to the ICE Administrator.
(No audit can be posted without a signed letter.)
2. Scheduling Coordinator compiles the listing of
all HPs audit dates
3. Scheduling Coordinator distributes the Shared
Credentialing Audit Schedule to all HPs
7. Scheduling Coordinator updates the schedule
after each meeting and sends to ICE for
posting on the website and sends to HPs
4. Once the auditing HP has been determined, each
HP may cancel their own audits
8. Scheduling Committee meets monthly to
negotiate the upcoming audit schedule
Conduct Audit
1. Auditing HP audits Provider Organizations
2. Auditing HP informs the PO of their
preliminary audit results
Audit Posted
ICE Shared Credentialing Scheduling Audit
Process
2
ICE Shared Credentialing Scheduling Audit
Process (continued)
Audit Posted
ICE Shared Credentialing Scheduling Audit
Process

• Auditing HP conducts audit and gathers data
  needed for
• Shared Audit Tool

• According to internal policies, HP will notify
  Provider
• Organization of results and intent to post the
  results on
• the Shared Credentialing Audit Tool form

1. HP conducting the audit completes the Shared
   Audit Tool

6. Provider Organization may decline to permit
posting of audit results

1. Auditing HP performs a verbal exit interview

• Auditing HP obtains signed copy of pre-posting
  letter
• if not received prior to audit date

Audit Results Used

1. Responsible HPs download the audit results from
   the ICE website

• Target for lag time between audit date and posted
  date 30
• calendar days

1. Responsible HP scores the audit according to
   their internal policies

• Auditing HP uploads completed audit into the ICE
  Web Site
• under ICAN

• The responsible HP reviews to see if additional
  information is needed if
• so, HP contacts Provider Organization

• HP notifies Scheduling Team members if Provider
• Organization declined to post and
  sends to ICE Administrator
• for posting on website

• Once all information has been obtained, the HP
  makes delegation
• determination and implements corrective action
  plan process
• according to its internal policies