Insurance Audit Checklist: How to Stay Prepared

There's plenty of helpful advice out there for mental health providers on how to prepare for an insurance audit, from long-form articles to webinars, but nothing beats a checklist when it comes down to figuring out exactly what you need to do — and tracking whether or not you've done it.

While some audits are triggered by "red flags" in provider documentation practices, others are conducted at random to ensure compliance with insurance company standards as well as federal regulations, including HIPAA.

The prospect of sharing records with auditors can be nerve-wracking and frustrating, but gaining a better understanding of what they're scanning for is the best way to stay prepared and protect your practice. Developed based on established protocols and expert advice, this simple and printable checklist is a comprehensive list of to-dos that will keep you on track to audit-proofing your practice.

In addition to steps that you can take immediately to work toward compliance, the checklist includes regular maintenance activities to add to your annual calendar to ensure ongoing readiness for unexpected audits.

Many clinicians feel caught off guard when they receive an audit notification, often scrambling to organize documentation and verify billing practices under pressure. This checklist can reduce that stress by establishing consistent protocols you can implement today.

If you have been taking steps to keep your documentation compliant, consider using this checklist to conduct a self-audit, ensuring that you haven’t missed any key elements.