Medtrade Spring preview: Get ahead of audits

Thursday, April 7, 2011

LAS VEGAS - Suppliers deal with an alphabet soup of contractor audits, with demands from ZPIC, RAC, MAC and OIG all taking time, money and resources. But effective internal audits can head off bigger problems and provide quality assurance for providers, says Clay Stribling, president of HC Comply, who will give a presentation at Medtrade Spring this week.

HME News: What percentage of providers would you say conduct internal audits?

Clay Stribling: I'm sure one-third of the companies are doing internal audits--and I'd like to believe as many as half.

HME: Has that percentage changed significantly in the past few years?

Stribling: It has increased; a lot more companies are becoming aware of the availability of resources to assist with internal audits. And these external audits that are coming through the contractors are forcing smaller companies to look inward and say, "How do we get ahead of this trend?"

HME: How should a company think about internal audits so there's total buy-in?

Stribling: Many companies get into an "us vs. them" mindset with their own internal auditors--resenting the fact that the internal auditors found errors. The only way you get where you need to be is to have a top-down approach that we are not going to tolerate any compliance lapses, any documentation lapses.

HME: How do internal audits help the provider to be better prepared for external audits?

Stribling: If you identify problems, you can address those problems. Even if the external auditors find the problems you found and take the money back, you can show the carrier or the ZPIC or whomever, "Look, I've already identified and corrected these problems through my audits two quarters ago."

HME: If a provider finds problems with an internal audit, what are the next steps?

Stribling: If they find a problem that is relatively common, not a fraud concern, go out and implement a corrective action, go train your staff. But if you find an issue that is truly an "oh my goodness type of problem," go get legal counsel involved. Without legal counsel you have no attorney client privilege for all this information you're gathering and the government can come in at any time and say, "Show us all your internal investigations and audits."

Name: Clay Stribling,

Title/company: President, HC Comply

Services provided: Program design, training, audit services, monitoring and reimbursement advocacy

Session: "Turning Your Company Inside-Out: How HME Suppliers Can Effectively Coordinate Internal and External Audits"

Time: Wednesday, April 13, 8:00 AM to 9:00 AM 

Contact: (806) 350-7422;

In brief: NCART conducts survey, CarePoint closes in on Florida

BUFFALO, N.Y. - NCART needs more current financial information from complex rehab providers, according to Don Clayback, executive director. "Having more current financial information will enable us to more effectively advocate with payers and policy makers to protect and improve access to complex rehab for people with disabilities," he stated in a bulletin to members. The newest information the coalition has is from 2007. As such, NCART is having the Simon Business School at the University of Rochester in Rochester, New York, conduct a confidential, 14-question financial survey with responses due May 6. Providers may attend a webinar at 3 p.m. April 15 to review the survey and ask questions. To attend, go to