What is a primary characteristic of retrospective audits?

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Retrospective audits are primarily designed to evaluate claims that have already been submitted to payers. This type of audit involves reviewing the documentation and coding associated with past services to ensure compliance with regulatory requirements and accuracy in billing. By assessing previously submitted claims, organizations can identify any discrepancies, address issues related to reimbursement, and enhance their overall documentation practices for future submissions.

This focus on past claims distinguishes retrospective audits from prospective audits, which take place before billing, and from concurrent audits, which occur during the billing process. Additionally, retrospective audits do not aim to correct errors during the billing process themselves; rather, they help organizations learn from past submissions to improve future practices. Hence, the option highlighting the assessment of claims that have already been submitted accurately captures the essence of what retrospective audits are all about.

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