Many of our healthcare and business law firm’s clients periodically face audits by insurance companies or governmental organizations, usually through a contractor. Audits can be unnerving times for a practice to go through. This blog post outlines 3 tips for handling an insurance audit. The Centers for Medicaid and Medicare recently published that the flexibilities allowed during COVID-19 will soon end and practices should ensure compliant safety and billing practices. As a result of this change after two and half years, practices may see increased audits. If you have questions regarding this blog post or need counsel navigating an audit, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, firstname.lastname@example.org. You may also learn more about our law firm by visiting www.hamillittle.com.
- Take it Seriously at the Initial Record Request (and Not Just When They Ask for Repayment).
Many practices call us after the auditor requests repayment. Almost always, the process starts before then with the auditor initiating an investigation by requesting additional records and information. After the repayment is requested, however, there is an uphill battle to argue on behalf of your practice that no or less repayment is warranted. The best chance that your practice has of both reducing any requested overpayment and persuading the auditor not to expand its investigation to more patients or a larger time period is during the response to the initial request for records and documentation.