Compliance Solutions

APCD refers to All-Payer Claims Database, a state-level initiative under the No Surprises Act. It collects healthcare data such as medical claims, pharmacy claims, provider details, and eligibility records. Compliance requires accurate, complete submissions validated against hundreds of state-specific rules and thresholds, often audited for financial accuracy and data integrity.

NAIC MAR stands for the National Association of Insurance Commissioners Model Audit Rule. It applies to insurance companies and focuses on internal controls over financial reporting similar to SOX but tailored for the insurance industry. Compliance demands transaction-level traceability, reconciliation across systems, and audit-ready documentation.

Audit evidence management refers to capturing and maintaining tamper-proof, time-stamped logs of all data movements and control executions. It includes versioned test repositories, scheduled runs, and machine-generated artifacts that auditors can verify without manual intervention.

Data lineage tracks the journey of data from its source to its final report. For compliance, it provides a defensible link between reported figures and source-of-truth data, ensuring outputs are verifiable and reproducible across environments.

Data reconciliation ensures consistency between different systems or layers (e.g., source vs. target, SQL vs. BI report). It confirms that reported numbers match original data, which is critical for financial and regulatory compliance.

Baselining involves creating reference points for ETL processes or regression tests. It helps detect deviations from expected results and ensures reproducibility across environments like Dev, UAT, and Prod.

Continuous monitoring uses automated tests and alerts to validate data integrity in real time. It replaces ad-hoc checks with scheduled validations, anomaly detection, and proactive notifications to prevent compliance breaches.