Quantcast
Business Resources
by Category








Try our "Virtual Buyers Guide!"
-flip through the pages!
-search by keyword!
-download to your desktop!
-forward to a colleague!
< Home  < Articles  < Article Details

 
 
Medicare: When the Auditor Comes Calling
How to best respond to — and prevent — a CMS audit
By Suz Redfearn

Let sleeping dogs lie, says Glaser.

“If you don’t hear from them, don’t call and check. No news is good news. Let it sit,” he advises. “Maybe they’ll forget about you — I’ve seen that happen.”

And be patient, he adds. Results from a Medicare audit can take months — even years. Put it out of your mind and remember that jail time for infractions is exceedingly uncommon — usually only seen when out-and-out fraud is apparent, says Glaser.

Yes, a Medicare audit can be a tremendous drag on your resources, time, and emotions — but if you can, focus on the upsides, suggests Wheeler. Surprisingly, she says there is more than one.

“In looking closely at your records during an audit, you may discover areas where you’re not capturing revenue to the greatest extent allowable by revenue rules — or you could find ways to tighten internal control that would help the bottom line,” Wheeler says. “Try and view the audit as an opportunity to shine and let CMS see what you’re doing right.”

Suz Redfearn is a freelance writer and editor with more than 10 years of experience writing about business and healthcare issues. She can be reached via editor@physicianspractice.com.

This article originally appeared in the June 2006 issue of
Physicians Practice.


Additional Resources
View more articles from the June 2006 issue

View more articles related to Legal

 
 


 

Home | Contact Us | Subscribe  | Site Map | Disclaimer | Privacy Policy | Change Zip Code
CancerNetwork | ConsultantLive | Diagnostic Imaging | Psychiatric Times
 SearchMedica

 Subscribe to Physicians Practice RSS

Connect with Physicians Practice on

           

Copyright © 2010 UBM Medica LLC,, a United Business Media company.
 
ADDITIONAL ONLINE RESOURCES FROM UBM MEDICA
Featured Resources > Pediatric Asthma > ASCO Conference Report > APA Conference Report > Consumer Healthcare Information > Patient and Caregiver Resource
CancerNetwork > Cancer diagnosis, treatment, and prevention > Podcasts for Oncologists > Cancer Patient Resources > Oncology Areas of Confusion > Oncology News > Cancer Management Handbook > Oncology E-Learning > Oncology Practice Management
Consultant Live > Practical Clinical Advice > Medical Photoclinic > Diagnosing and Treating H1N1 flu (swine flu) > Primary Care Conference Reports > Primary Care CME
Diagnostic Imaging > Medical Imaging News and Features > Medical Imaging and Radiology White Papers > Radiology Conference Reports > Radiology Special Reports > Radiology Careers > Radiology Net Seminars > Imaging Trends and Advances > CT Dose Issues and Articles > Molecular Imaging Articles
Psychiatric Times > Psychiatry Careers > Psychiatric News and Special Reports > Psychiatric Clinical Scales > Psychiatric Times Blog > Psychiatry Career Opportunities > Psychiatry CME > DSM-V
Physicians Practice > Practice Management > Practice Management Webinars > Medical Buyers Guide > Medical Coding > Practice Management Tools > Practice Management Podcasts > Today's Practice - Practice Management Resource
SearchMedica > Professional Medical Search > Medical Search Tips Newsletter > Medical Search News



 
 
-- Advertisement --


In Summary
Receiving notice that you are the subject of a Medicare or Medicaid audit by CMS can be very frightening. Take these steps to ensure your practice is in order:

  • If CMS sends your practice an audit letter requesting copies of records, contact your attorney immediately. He or she will help you determine whether CMS is doing a routine review or a targeted investigation.

  • Before sending the requested records to CMS, it is advisable to have your attorney contact a coding consulting company on your behalf to determine what CMS may be looking for. This makes any mistakes you find legally undiscoverable.

  • Work swiftly to send CMS the records it has requested. Assign the matter to one person in your office who can handle it efficiently and responsibly.

  • To avoid an audit in the first place, adhere to a strict, ongoing compliance plan that includes internal audits twice a year as well as frequent staff training.

  •