Latest Wave of MU Audits Delivers a Fresh Scare
This particular audit process dragged on. After four or five go-rounds with the auditor hired to do Texas-specific audits, "they finally just said, 'you just need to send us every single claim that you produced,' and we could de-identify it, but they wanted to know who the payer was and how much we were paid, and whether we were denied, for all payments, not just Medicaid.
"That was a surprise to us, and I challenged it all the way up to CMS, and I was told that that was a valid request. So be prepared for that."
Some providers, including McNutt, have even received phone calls as part of HHS's Office of Inspector General's effort to audit the auditors in each state.
At CHIME, I happened to mention this to former National Coordinator Farzad Mostashari, whose response was a shrug, signifying that this is the way things go with audits at times.
McNutt's co-presenter during the CHIME Webinar was Liz Johnson, vice president of applied clinical informatics at Tenet Healthcare, which has received nineteen audit notices so far. Tenet has the added headache of operating in 22 states, making its challenge and learning experience exponentially greater than Methodist's.
In some cases, the audit notice got to Johnson with only two days left to respond. "We did call and get a few extra days, but it is one of those things where you want to stay on top of it," she said.
- As Medicare Advantage Cuts Loom, Disagreement Over Program's Stability
- Medicare Advantage Carriers See 'No Choice' But to Accept Cuts
- Centralizing the Revenue Cycle Protects the Bottom Line
- Physicians to Appeal 'Docs v. Glocks' Ruling in FL
- CA Fines 8 Hospitals for Medical Errors
- 3 Management Lessons from a Supermarket Debacle
- Doctors Feel Pressure to Accept Risk-based Reimbursement
- Employers Weigh Risks, Benefits of Private Exchanges
- Surgical Checklists Unused in 10% of Hospitals, CMS Data Shows
- Revenue Cycles Get a Boost from Simple JPEG Files