The Pulse Podcast: Tackling Post-Payment Audits


As audits are increasing across the country, you need to know how to defend your reimbursements from payers and CMS. In this episode of The Pulse, Lori Cox sits down with Michael Miscoe, an accomplished attorney, coding and software development professional, and former President of AAPC’s National Advisory Board.  

They discuss post-payment audits and clawbacks, dive into statistical samples, and share insights on defending coding accuracy, when to seek legal advice, and how to leverage third-party support if audited or fined.  

Listen above to: 

  • Explore the best approach for compliance plans, especially for smaller physician practices. 

  • Uncover the complexities of auditing medical claims, including identifying and correcting errors in E/M services. 

  • Discover distinctions between federal healthcare program claims and non-federal claims, unraveling the obligations triggered by potential incorrect payments. 

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