Medicare Compliance & Reimbursement

Audits:

This MAC Shares the Dirt on 4 Common Audit Types

Chinese restaurant menu didn't cut it as documentation for one hospital. Does it sometimes seem like various Medicare auditors are coming at you from all directions? That's because there are four different types of auditors that can request Medicare records from you. Trailblazer Health, a Part B MAC in five states, cleared up the issue during its Feb. 8 webinar, "Medicare Documentation and Audits." Four types of audits exist for Medicare practices, said Trailblazer's Sherrie Varner during the Trailblazer session. Read on for the scoop about each type. 1. Medicare Administrative Contractor (MAC) Your MAC processes claims and can perform pre-payment and post-payment reviews. If your MAC identifies you for an audit, it will send you an ADS letter, typically asking you to submit specific documentation. Important: Be sure to review both the front and back of the ADS letter to ensure that you send all of the claim documentation [...]
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