Affiliated Provider audits

To make sure Affiliated Providers (APs) are complying with the terms of their AP agreements, audits are regularly undertaken by Southern Cross.

The annual audit schedule is set annually and indicates which specialties will be audited and when. Please note, you will only be audited on the rights and obligations under your AP agreement. An AP may be asked to participate in two types of audits.

Standard audit: This involves auditing compliance with an AP agreement and will originate from the annual audit plan. 

Follow-up and ad hoc audits:
These take place when we have identified irregularities or possible AP agreement breaches in a standard audit, or as a result of data analysis or other investigations. These audits may also be essential to confirm that required changes have been put in place after a standard audit or as a means to establish whether an issue is systemic.  

Completed audits

Current audits

Future audits

Skin specialists

  ENT - adenoids and grommets

Cardiology - CTCA

Oral surgery


General surgery - cholecystectomy

Ophthalmology - cataracts and related procedures

Medical - radioactive iodine

General surgery - skin GA procedures

General surgery - gastric banding/bypass            
 Urology - prostate laparoscopy  
 ENT - balloon sinuplasty (deferred)    

Notice of an audit

Affiliated Providers (APs) will be given no fewer than five working days’ notice of an audit. However, if the audit's integrity is at risk of breach or a serious specific incident has occurred, APs will be given 24 hours' notice.

Audit results

Audit results are kept confidential between you and Southern Cross. Identifiable personal information will not be recorded in audit reports.
Please direct any questions to or call the Provider line on 0800 770 843.