Audits threaten providers

YARMOUTH, Maine - The onslaught of audits shows no signs of abating, according to the results of a recent HME NewsPoll.

Seventy four percent of respondents say they were audited more frequently in 2011 than in 2010.

"Audits have nearly brought us to our knees," said Tom Black, CEO of Mobility and More in Loveland, Colo., who has experienced payment delays of 60 days or more. "This cannot continue or we will be gone."

The majority of respondents say up to 10% of their claims were audited in 2011.

In addition to cash strangleholds created by audits, the process is just plain expensive, say providers.

"We have estimated the extra cost of manpower and consultants to be in excess of $150,000 to get these claims paid," said one provider.

That provider is in the minority when it comes to bringing in outside help: 74% of respondents say they prefer to handle audits in-house, albeit at a cost.

"We've had to dedicate a full-time employee to do nothing but respond to audits," said Joey Graham, director of operations & administration for Pensacola, Fla.-based Gulf Medical Services.

Even though they're dedicating extra resources to handling audits, providers say they just can't respond to each one.

"It is too time consuming to chase down, copy and send the request information," said one provider. "Also, payment is delayed waiting for the audit review."

But for those who do, it often pays off in the form of fewer future audits, they say.

"Initially, the audits were frequent," said Jim Clark, president of Clark Respiratory and Medical Supply in Catskill, N.Y. "We win most of them. We believe our track record is proving us a low risk."