Generating a Random Sample of Cases

If the audit coordinator chooses to randomly generate a sample of cases to be audited, the audit coordinator will be presented with a list of queries that may be used to determine the cases that will be audited. The queries available for selection depend upon what queries have been configured in the administration application for the type of case being audited and also whether or not an external service may be used.

Dynamic Query

When a dynamic query is selected, the audit coordinator must enter the selection criteria that will be used to search for and randomly select cases, such as case status and a case start date or case end date range. One or all of the selection criteria available may be entered. Once the search criteria are entered, the audit coordinator will then be presented with information on the number of cases that were identified that matched the selection criteria entered, and must then indicate how many of the cases returned should be selected for audit.

Fixed Query

When a fixed query is selected, no selection criteria are required to be entered by the audit coordinator as the query already has selection criteria predefined, for example, all cases with a status of 'Active' that were opened within the month of February. Similar to the use of the dynamic query, once the audit coordinator has selected the fixed query that is to be used, the audit coordinator will then be presented with information on the number of cases that were identified that matched the selection criteria entered, and must then indicate how many of the cases returned should be selected for audit.

External Service

When an external service exists the audit coordinator is also presented with an option to select this external service. If selected, the external service case list is reduced to only those cases that match the type of case being audited. As with a fixed query, selection criteria are not required. The external service is another way to return a list of cases from which the audit coordinator may select the number of cases to be audited.

For each of the options available the audit coordinator must indicate how many of the cases returned should be selected for audit. This can be done by either specifying a percentage of the number of cases returned or by specifying an actual amount. Once the number of cases has been identified, the audit coordinator may then enter parameters for the algorithm that will be used to randomly select the number of cases chosen, e.g. the sample algorithm provided requires a 'starting point' and 'interval', and if 10 is specified for both values, case selection will commence at case 10 and skip every 10 cases until the required number of cases have been identified. If the audit coordinator chooses not to enter this information it will be selected by the system. A random selection of cases will then be generated and once confirmed by the audit coordinator, the cases identified may then be assigned for audit.

When an audit coordinator chooses to produce a list of cases with the use of a query, no cases may be removed from the list or added to the list. The audit coordinator, however, may subsequently choose to regenerate a completely new random list of cases but must reenter selection criteria. This will result in a new list of cases to be audited. Note that this may only be done if the case list was originally randomly selected and no cases have yet been assigned for audit.