If you're a physician, and you see patients who are covered by Medicare, you already know that you need to pay close attention to the rules and regulations. That's because Medicare sends forth an audit as soon as they notice any type of discrepancy in the records. Unfortunately, some physicians aren't even aware that a discrepancy exists until they receive the audit notice. By that time, it's too late to avoid the situation. Luckily, there are steps you can take to reduce your risk of a Medicare audit, especially if you take a proactive approach. Here are some steps you can follow to help you avoid a Medicare audit.
Understand the Red Flags
When it comes to protecting your practice against Medicare audits, the most important thing you can do is understand the red flags. Those are the indicators Medicare officials look for when determining the need for an official audit. If you can avoid raising those red flags, you can help to reduce your risk of an audit. First, consider limiting your use of the exception rule for excessive treatment appointments. Second, be sure each provider in your practice bills under their own provider number. Finally, avoid submitting large batches of bills for similar services on the same day. You can prevent that risk by having your accounts manager submit bills as they come instead of waiting for large batches.
Ensure Proper Documentation
If you want to avoid a Medicare audit for your medical practice, it's crucial that you ensure proper documentation for all procedures, and for all submitted bills. Documentation should include actual dates for specific treatments, certification for patient care plans, and physician signatures. Many practices use stamps for physician signatures, but that practice could increase the risk for a Medicare audit.
Avoid Suspicious Billing Practices
If you're worried about Medicare audits, take a look at the way your services are billed, especially if you have non-physicians providing any of the services you offer. For instance, if your practice provides physical therapy treatment, make sure that your Medicare billing reflects when technicians are provided certain patient treatments. Also, if you need to provide extended treatment for a patient, be sure that the billing statement reflects the reason for the extension.
Work With a Medicare Audit Service
Finally, if you want to avoid a Medicare audit, start working with a Medicare audit service. These services can help you to avoid the mistakes that can lead to an audit. If you've already been audited, an audit service can help you to rectify the issues that were discovered during the audit. Contact a service for more information, such as for Medicare Part D plan audits.Share