Comprehensive Compliance, Interim Staff & Audit Solutions
At Rebellis Group, we provide expert compliance and audit support to help health plans and organizations navigate the complexities of regulatory requirements. From advisory services to internal and external audits, remediation, and delegation oversight, our team ensures your compliance framework is both effective and future-proof.
End-to-End Compliance & Audit Support
Our comprehensive compliance solutions help you maintain operational integrity, minimize risk, and optimize performance:
✔ Compliance Program Build & Implementation
Develop and execute a structured compliance program aligned with regulatory requirements.
✔ Outsourced Compliance Monitoring & Auditing
Continuous oversight through external monitoring and audit support.
✔ Application Support
Expert guidance in navigating compliance applications and regulatory submissions.
✔ First Tier, Downstream & Related Entity (FDR) Oversight
Ensure accountability and compliance across all delegated entities.
✔ CPE/IVA/Focused/Mock CMS Program & Financial Audits
Identify and address potential risks before CMS audits with our comprehensive mock audit services.
✔ Utilization Management (UM) Audit Support
Ensure compliance with UM regulations through thorough audit preparation and response strategies.
✔ Claims & Appeals Audit Support
Strengthen compliance processes related to claims and appeals management.
✔ Audit Remediation & Independent Validation Audits
Resolve audit findings efficiently and validate corrective actions for long-term compliance.
✔ CMS Audit Support
Navigate CMS audits with expert assistance, from preparation to response strategies.
✔ Corrective Action Plan (CAP) Development & Review
Implement and refine CAPs to mitigate compliance risks and maintain regulatory alignment.
✔ Compliance Advisory Services
Gain expert insights tailored to your organization’s compliance challenges.
✔ Third-Party Marketing Organization (TMO) Oversight
Ensure CMS marketing compliance and regulatory adherence.
✔ Agent/Broker Oversight
Monitor and manage agent and broker activities to reduce risk and maintain compliance.
Stay Ahead with Rebellis Compliance Subscription
Never miss a regulatory update with Rebellis Academy, our subscription-based compliance education service designed to keep your team informed and prepared.
✔ Ongoing Regulatory Summaries
Get real-time updates on policy changes and compliance requirements.
✔ Expert-Led Training
Stay ahead of industry shifts with regularly updated training sessions led by compliance professionals.
✔ Convenient & Scalable
Flexible training solutions tailored to your team’s needs, ensuring compliance at every level.
Proactive Compliance with Rebellis Group
Our mock audits serve as a verification process to confirm that your compliance and operational procedures meet regulatory expectations. These audits strengthen existing systems, uncover opportunities for improvement, and reduce the risk of future errors.