Pharma Reimbursement HUBs: To Audit, or not to Audit?


Here’s a pharma industry brainteaser: What is sometimes a noun, sometimes a verb, and almost always terrifying?

Answer: An audit

In previous roles, I immediately panicked anytime I heard the term “audit” I would begin mentally preparing for what, in my mind, was an outside entity coming in to scrutinize the work of my organization.

Now I see that I had it all wrong. Audits aren’t terrifying; they’re enlightening.

As a consultant, I conduct audits on behalf of pharmaceutical clients and have come to appreciate the other side of the audit story. While the norm is to view an audit as a stressful, time-consuming experience, I’ve learned that audits can paint a picture not visible to the naked eye and are a valuable exercise to gauge the current health of a program.

When we begin working with a new client, we always ask: what’s the current health of your program? Often, the honest answer is “I don’t know.” As alarming as that sounds, it is not uncommon, and it’s something that can be fixed.

As our team is fond of saying, “You don’t know what you don’t know.” And If you want to know, it is time for an audit.

Frequently, when we start working with a client, they have already identified potential issues with their program but are unsure of where the breakdown is occurring and where to start to remedy the issues. Below are a few key questions we ask clients when considering a potential audit.

If you’re unsure of the health of your program, ask yourself these questions. If any of the answers are “no,” it may be time for an audit.

  • Are SLAs/KPIs being met?

  • Are SOPs/Business Rules up to date?

  • Are quality standards being met?

  • Have the individuals on the front line who interact with your stakeholders been adequately trained to perform their job responsibilities?

  • Is your vendor engaged and meeting your needs?

Even if the answer is yes to all the above questions, performing an audit can be a proactive measure in identifying future improvements for the continued success of your program. As the old saying goes, it is better to be proactive than reactive.

If your organization is interested in performing an audit or you want to discuss the health of your program, Archbow Consulting is here to do the heavy lifting for you. Our team has an average of 20+ years’ experience and can provide an objective, third-party assessment along with recommendations to optimize your program. Contact us today to get started.


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info@archbow.com

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