Availability is a low bar
Data being available somewhere in the organization, in a system, a file, an archived record, is a low bar that most organizations already clear. It says nothing about how long it takes to find, whether it is connected to the decision it is meant to support, or whether it is complete enough to answer the question being asked of it.
Defensible means connected, timely, and complete
Defensible data is data that can be produced quickly, that is clearly tied to the specific decision or claim in question, and that does not have gaps that raise more questions than it answers. Those three properties are not automatic outcomes of storing data well; they are the result of designing, from the start, for the moment the data will need to be produced under scrutiny.
The design decision has to happen before the audit, not during it
By the time an audit or a dispute arrives, it is too late to redesign how evidence was captured for the decisions already made. The organizations that hold up well under scrutiny made the decision to capture evidence as connected and complete well before any specific audit required it.
How Embel Assist helps healthcare organizations establish the evidence behind payments, providers, and program integrity.
Read the challenge in full: Proof, Integrity and RADV