Surviving an audit
By HME News Staff
Updated Tue 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.
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