Surviving an audit

Tuesday, July 31, 2007

Problematic intake is the biggest reason why HME providers get audited and why they, in turn, call Peggy Walker for help. Walker, a Columbia, S.C.-based billing and reimbursement advisor for The VGM Group's U.S. Rehab, has plenty to say about what providers should do to survive an audit.
HME: How do providers react when they're notified of an audit?
Walker: It scares them. They think someone is going to close them down. Usually, they have nothing to fear. It's usually a pre-pay or post-pay audit conducted by the payer, looking for a CMN or other documentation to back up a claim.
HME: Where are providers most deficient?
Walker: Definitely order intake. They often fail to ask the right questions at the right time. They are busy and it's a common oversight. It's nothing intentional; they need to prioritize.
HME: What are the most common misperceptions providers have about audits?
Walker: A lot of people feel they won't get audited because of the belief that auditors will only go after the big guys. But it's a random process; no one really knows who will get selected.
HME: Advice?
Walker: Staff education is a priority. Everyone needs to be educated about audits.