What CMS audit solutions does Atlas Systems offer?

Atlas Systems delivers CMS audit solutions that cover data validation, documentation review, compliance monitoring, and audit tracking. These services are structured to support healthcare payers in meeting federal oversight standards.

How can Atlas Systems help healthcare payers prepare for a CMS audit?

Atlas Systems works with payer teams to review documentation, identify potential gaps, and organize materials that align with CMS protocols. The audit preparation process includes pre-audit risk assessments and support with submission readiness.

How does Atlas Systems' CMS audit solution help mitigate compliance risks?

The solution identifies inconsistencies in provider data, credentialing records, and other critical documentation. By flagging issues early, healthcare organizations can address them before they result in audit findings or penalties.

Does Atlas Systems provide mock CMS audits?

Yes. Atlas Systems conducts mock CMS audits that simulate real audit conditions. These exercises help organizations test their readiness, uncover vulnerabilities, and prepare staff for formal review processes.

Can Atlas Systems assist with corrective action plans after a CMS audit?

Yes. If an audit reveals findings, Atlas Systems helps organizations build and implement corrective action plans. These plans include root cause analysis, documentation updates, and timeline tracking to support compliance closure.

Can Atlas Systems' CMS audit solution integrate with existing compliance management systems?

Yes. The solution integrates with various compliance tools and platforms already in use. It supports data import and export from most major systems used by healthcare payers.

How quickly can Atlas Systems’ CMS audit solution be implemented?

In most cases, implementation takes fewer than 30 days. The process includes configuration, data onboarding, staff training, and live support.

Is Atlas Systems’ CMS audit solution customizable for different healthcare payers?

Yes. The solution is designed to adapt to the structure, priorities, and audit processes of regional, state, and national health plans. It supports different lines of business and regulatory reporting requirements.

Stay Ahead of NCQA’s Latest Standards Without the Rush

NCQA now requires faster credentialing timelines, monthly monitoring, and updated demographic data. Choose Atlas PRIME®, a complete turnkey solution to stay compliant and audit-ready.

With Atlas, you get:

Primary source verification automation
Monthly license and exclusion monitoring
Audit-ready documentation and workflows

Confidently Meet NCQA’s 2025 Requirements with Atlas PRIME^Ⓡ

Compliance Isn’t Optional — And The Deadline Is Set

Starting July 1, 2025, NCQA’s updated credentialing standards will apply to all surveys. These changes introduce shorter verification timelines, monthly exclusion checks, stricter data integrity rules, and a merged accreditation-certification model.

Health plans must now:

Complete primary source verification in 120 days (or 90 for certification)
Conduct monthly Medicare/Medicaid exclusion checks
Track and log all credentialing file changes with full transparency
Collect voluntary demographic data with non-discrimination disclosures

NCQA Changes Got You Scrambling? Atlas Can Help!

PRIME® by Atlas Systems is built to handle the latest NCQA credentialing standards with speed, precision, and full audit readiness. Effortlessly hit verification deadlines, automate monitoring and PSV, maintain full audit trails, update practitioner forms, and keep your team trained on annual changes.

Faster credentialing
 (120/90-day verification timelines)

Monthly license and
exclusion monitoring

Updated apps with
race/language fields

Full audit trails for
file changes and actions

Automated
workflows and source verifications

No-stress NCQA survey readiness

Partner with Atlas today and stay ahead of NCQA deadlines!

Talk To Us

FAQs About NCQA’s Latest Standards

What are the biggest NCQA credentialing changes for 2025?

NCQA now requires faster verification (120/90 days), monthly exclusion checks, stricter audit trails, and voluntary demographic data collection for practitioner applications.

When do I have to comply with the new standards?

The updated NCQA credentialing rules apply to all surveys on or after July 1, 2025, so your program must be ready before that date.

How does Atlas PRIME® support NCQA compliance?

Atlas PRIME® automates PSV, monthly monitoring, practitioner data updates, and audit trails — keeping you fully survey-ready and compliant with 2025 requirements.

Is it mandatory for providers to answer race and language questions on the
application?

No. These questions must be included, but practitioner responses stay voluntary. NCQA requires you to state clearly that answers will not be used to discriminate against a practitioner.

What if my program doesn’t meet the 2025 NCQA standards?

Missing compliance could risk your accreditation, disrupt payer contracts, and expose patient safety gaps. Atlas helps you avoid those risks confidently.