North Carolina: Time to collect audit data

Friday, May 24, 2013

RALEIGH, N. C. – When it comes to audits, Kim Brummett says it’s time for providers to go from defense to offense. 

“We talk about audits all the time,” said Brummett, immediate past president of the North Carolina Association for Medical Equipment Services, and senior director of regulatory affairs for AAHomecare. “We need to quantify it. Providers need to say, ‘It feels like we get tons—is that really the case?’”

Brummett created an Excel spreadsheet for providers to use to keep track of audits by type and code, as well as a provider’s success at appeals. NCAMES sent the spreadsheet to members after the association’s annual meeting in February.

Brummett says she’s not against audits, but that their goal should be to seek out fraud, not burden trustworthy providers.

“All of us want the fraudsters to go away,” said Brummett. “That’s better for everybody.”

Provider Frank Trammell says audits are out of control, and he expects that the data, once compiled, will prove that. 

“The numbers are going to be pretty clear,” said Trammell, president of Carolinas Home Medical Equipment in Matthews, N.C. “We eventually get paid and the documentation hasn’t really changed. This will give us something to show Medicare and the Senate Finance Committee, and demand some answers.” 

Brummett hopes North Carolina’s efforts will feed into the AAHomecare Regulatory Council’s work to compile data on audits on a national level, an effort that started in March. Rachel Prager, manager of regulatory affairs, says it’s important to make sure audits are fair and accurate.

“When you have providers who are responding and doing everything they can, and the error rates aren’t going down, there’s something wrong with the system,” said Prager.