Self-Audit Protocol.

Sample and check your own claims on a rhythm, exactly as an auditor would, so you find and fix problems before a payer does.

The second step of protecting against clawbacks, on a set schedule (quarterly is common).

Part A. Sample and score

Pull a sample of paid claims and check each against its documentation and the contract rules, as an auditor would. Claims checked, how many held up, problems found

Part B. Fix and, where required, disclose

Fix the process behind any problem. Where the self-audit shows you were overpaid or billed something you should not have, there may be a legal duty to report and repay it, and doing that correctly is a question for a nonprofit accountant or attorney. Process fixes and professional-guided repayment or disclosure plan

The point: a problem you caught and corrected is far safer than one an auditor finds.

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