• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Outside Audit

Create Wiki
L

livininthegray

Contributor
Messages
16
Best answers
0
About 4 months ago we had an independent co. come and do and audit for a Med. Advantage plan and now they are requesting to do another audit of the same charts and same time frame. Do I have to let them do the re-audit? Where would I look for any rules that may apply to whether or not they are allowed to do a re-audit of our charts. This is very time consuming for us to pull over 100 charts. I have not talked with the auditing co. as yet as to why the re-audit, but if the re-audit is because there people did not do it correctly the first time am I legally obligated to allow the re-audit?
 
Whatever the reason, you could be obligated. Might be a good idea to check your contract with that specific MA plan.

I would definitely call this company and ask why they are doing the same charts for the same time period...that definitely doesnt make sense. You might luck out and it be an error.
 
Was this an HCC audit? If so, all they are looking for are specific diagnoses so that the MA can get more money from Medicare. Pretty much a benign audit. Regardless, I believe you are obligated to follow through but definitely get more information as to why the repeat audit is needed.
 
I talked with the Med Adavantage representive and the reason for the re-audit is because there auditor did not collect the correct data. Would it be unreasonable to charge a fee and if so what can if anything can I do if they refuse?
No this is not a HCC audit.
 
You must log in or register to reply here.
Top