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For a provider of healthcare services, payor audits are always a possibility. Government payors and commercial insurance companies rely on pre- and post-payment medical records and billing audits to determine whether provider services were medically necessary, accurately billed and appropriately paid. Over the past few years, Medicare significantly increased the types and numbers of audits and outsourced many of the record reviews to private companies.
With so many of these private companies conducting audits on behalf of the Medicare program, it is not a matter of whether a provider will be audited, it is a matter of when. To help alleviate some of the tension surrounding the audit process, providers must be proactive and understand what types of audits exist and how to prepare for the possibility.
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American Osteopathic Association
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Speaker: Vicki Myckowiak, Esq.