Medical providers have long been subject to regular audits by public and private payers. However, with the outbreak of the COIVD-19 pandemic and the resulting high expenses for COVID-19-related testing and treatment, there has been an increase in payer audits. If a provider receives a notification of a forthcoming audit or a demand for overpayment, it is crucial to take specific measures to appropriately challenge the findings, mitigate risk, and avoid the possibility of civil or criminal referral. Familiarity with the nuances of various payer audits, the ability to respond to each type of audit, and the ability to avoid common mistakes can mean the difference between successfully defending an audit and having to repay a substantial sum.
In a recent article published in the American Health Law Association’s Journal of Health and Life Sciences Law, Frier Levitt attorney Guillermo Beades and Healthcare Compliance Network’s James Tudor discuss the steps providers need to take to properly refute findings, reduce risk, and avoid potential civil or criminal referral. Don’t let a payer audit catch you off guard.
Read the article here.
