Challenges and AI solutions for HCP engagement expense auditing

Managing and auditing healthcare professional (HCP) engagement expenses effectively is essential for regulatory compliance, yet traditional methods used for this function are becoming increasingly inadequate, according to qordata.

A recent white paper by qordata, titled “How AI is Reshaping HCP Expense Auditing,” examined the challenges companies face with HCP expense auditing and addresses how AI is changing these processes for compliance professionals.

Challenges

The key challenges in traditional HCP expense auditing, include:

• Fragmented data sources: HCP expenses located across multiple systems require manual consolidation, increasing error risk.
• Limited audit coverage: Traditional methods, such as manual processes, typically review only 20% of expenses, leaving 80% unchecked.
• Compliance complexity: Organizations struggle to consistently apply regulations like the Anti-Kickback Statute and Sunshine Act.
• Financial and reputational risk: Undetected violations can lead to significant penalties and damaged reputation.

The AI solution

Additionally, the white paper outlined how AI-enhanced expense monitoring addresses these challenges:

• Automation of data integration: AI systems can integrate data from multiple sources, eliminating manual consolidation errors while expanding audit coverage to 100%.
• Comprehensive audit coverage: Expense reports can be rapidly analyzed to detect anomalies and policy violations.
• Consistent application of compliance rules: AI ensures uniform application of compliance policies and regulatory requirements.
• Continuous risk monitoring: Real-time anomaly detection and risk assessment is enabled, allowing for immediate intervention when suspicious patterns emerge.
• Enhanced transparency: Modern auditing solutions provides detailed audit trails and comprehensive reporting capabilities.

The white paper concluded that as regulatory scrutiny continues to increase, companies “seeking to mitigate financial and reputational risks should consider adopting AI-driven solutions to modernize their expense auditing processes and ensure robust oversight of HCP engagements.”

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