AAPC - Back to school
Results 1 to 4 of 4

Thread: Outside Audit

  1. #1

    Angry Outside Audit

    AAPC: Back to School
    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?

  2. #2
    Join Date
    Apr 2007
    Kansas City, MO


    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.

  3. #3
    Join Date
    Apr 2007
    Greeley, Colorado


    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.
    Lisa Bledsoe, CPC, CPMA

  4. #4


    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.

Similar Threads

  1. Audit
    By cperk in forum Billing/Reimbursement
    Replies: 0
    Last Post: 07-09-2014, 11:56 AM
  2. E/M Audit - Denver - Need an audit done
    By skneefel in forum Auditing General Discussion
    Replies: 1
    Last Post: 07-23-2013, 07:24 AM
  3. E/M audit for ER
    By Tammy Todd in forum Auditing General Discussion
    Replies: 0
    Last Post: 09-21-2010, 10:45 AM
  4. -59 audit
    By LTibbetts in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 03-17-2010, 06:49 AM
  5. How much should I audit?
    By cdcpc in forum E/M
    Replies: 4
    Last Post: 09-12-2008, 07:48 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.