Which audit-related process might a selected plan need to perform under CMS guidelines?

Under CMS guidelines, when a selected plan is undergoing an audit, it may need to request medical record documentation. This process is essential as it allows the plan to validate the accuracy of the data submitted for risk adjustment and reimbursement purposes. The provision of comprehensive and accurate medical records is crucial to demonstrate that the diagnoses attributed to beneficiaries are supported by clinical evidence documented during the care provided.

Additionally, when audits are conducted, the focus is on ensuring that the services billed were necessary and that the diagnosis codes submitted are applicable and substantiated by the actual medical treatments received. Therefore, requesting medical record documentation aligns directly with the goal of maintaining compliance with CMS standards, ensuring the integrity of the data that impacts funding and quality of care initiatives.

The other options pertain to different processes that may not directly relate to the immediate actions triggered by an audit. For example, while analyzing beneficiary data can occur as part of ongoing monitoring, it is not a direct response to an audit. Similarly, implementing new diagnoses and requesting payment adjustments may arise in different contexts, but they are not core actions specifically tied to the audit-related process identified by CMS.