Case Management
Audit Preparation Checklist
Get your case management files audit-ready with this step-by-step checklist.
Whether you're facing a scheduled audit or want to be ready for any review, this checklist will help you organize your case files and documentation. Use it as a regular self-audit tool to stay prepared year-round.
Eligibility Documentation
Level of care assessment completed and current
Medicaid eligibility verification documented
Freedom of choice form signed and dated
Participant rights acknowledgment signed
HIPAA consent forms current
Service Plan Documentation
Current service plan within effective date range
Plan signed by participant (or legal representative)
Plan signed by case manager
All services listed with authorized units/hours
Goals are measurable and person-centered
Risk mitigation strategies documented
Backup plans for critical services documented
Provider information accurate and current
Contact Notes & Monitoring
Required monitoring visits completed on schedule
All contacts documented with date, time, duration
Contact type (face-to-face, phone, etc.) recorded
Purpose and outcome documented for each contact
Notes connect to service plan goals
Health and safety addressed in monitoring notes
Service verification documented
Incident & Change Documentation
All incidents reported within required timeframes
Incident follow-up documented
Service plan amendments documented when needed
Significant changes in condition documented
Level of care reassessments completed when required
Billing Support
Services billed match services documented
Billed units don't exceed authorized amounts
Service dates match documentation dates
Medical necessity supported by documentation
File Organization
Documents in chronological order
All documents legible
Electronic files accessible and organized
Able to pull any file within required timeframe
Pre-Audit Action Items
When you know an audit is coming:
- Review the specific audit criteria/protocol being used
- Pull sample files and self-audit using this checklist
- Fix any gaps you find before the audit
- Prepare staff who may be interviewed
- Organize a workspace for auditors
- Have key documents readily accessible
Stay Audit-Ready Year-Round
One Care Portal automatically tracks documentation compliance and alerts you to missing or expiring documents. Run audit reports anytime to see exactly where you stand.
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