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Thread: Auditing errors

  1. #1
    Join Date
    Apr 2007

    Default Auditing errors

    AAPC: Back to School
    Can some of you who do auditing tell me how you handle the errors that you find? Some for example, if you find something that was billed that should not have been billed, and insurance has already paid. How do you handle missed charges? Is there a proper protocol to follow, or should that be established per practice?

  2. #2
    Join Date
    Apr 2007
    Brandon, FL


    If you find something that should not have been billed and was paid, you need to submit a refund to the insurance company. Some companies (MCR, BC,..)have specific forms for you to sumbit with the refund explaining the error. Go to their website and search forms. If you missed a charge and are still within the filing limit, submit the charge; if outside the filing limit you probably lost that opportunity for payment.

  3. #3
    Join Date
    Apr 2007


    You need a formal policy in order to cover yourself in this situation. I am dealing with this situation right now. I do my audits and give the detailed reports to the people involved, I am not personally responsible for billing nor do I have access to do anything with the billing. It appears someone dropped the ball on an audit I did in March and didn't correct the errors that I found so they are asking me why it didn't get done. I will be drafting up a policy and hopefully get it in place next week so if this happens again they can't point fingers.

    Any errors that are found should be corrected and it should be logged that they were along with the audit results.

    Laura, CPC, CEMC

  4. #4
    Join Date
    Apr 2007
    Swainsboro/Statesboro, GA

    Default Errors

    Once an error is discovered, it should be corrected.
    Freda Brinson, CPC, CPC-H, CEMC
    2014 President AAPC Swainsboro, GA Chapter
    Past President - 2012, 2008; Past Vice President - 2013, Past Education Officer - 2009 of Savannah, GA Chapter
    Past Member AAPCCA Board of Directors (2009-2012)

  5. #5

    Default Re: Auditing Errors

    This is what the RAC audits are all about. Realize that once an error is found it needs to be corrected - or it could become a compliance issue. The OIG and RAC, MIC etc... all looking at ways to take your $$$ back.

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