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Boston Medicaid Healthcare Audit Lawyers

Medicaid audits are something that healthcare providers have to deal with. Hiring legal counsel to help you handle them is the best way to get through the audit process without any frustrations.

It’s standard procedure for healthcare providers to be audited occasionally to make sure that they are properly charing the Medicaid program for payment on the services they provide. Of course, those who run healthcare facilities are generally too busy to handle the details of an audit themselves, so hiring an experienced Medicaid audit lawyer is important.

You should understand some basic factors about audits before you proceed with filling out the necessary documents and supplying the necessary records.

Why am I being audited?

Healthcare providers sometimes feel singled out or accused when they receive an audit. However, it’s important to know that an audit can occur randomly. Audits are intended to make sure there is no fraud or inaccuracies in your dealing with the Medicaid program. As long as you have records of your Medicaid claims and can show that they were all appropriately filed, you shouldn’t have any problems.

You may have already experienced an audit before and handled it successfully. Yet an additional audit could come from a different contractor that handles things a little uniquely. This can make your past audit experience invalid. Seasoned Medicaid audit lawyers specializing in healthcare have specific experience with many different types of audit contractor. They therefore can offer great assistance and deal with the audit more effectively than you could while you continue with your main job tasks.

Below are four things you should definitely realize as soon as possible when you’re undergoing the audit process:

  • You need to find out who exactly is responsible for your being audited- These days, Medicaid audits have increased in complexity due to the fact that there are a variety of different contractors in charge of them. Your lawyer needs to know who your audit’s coming from to handle it appropriately. An audit can come from a government agency or a private contractor. Commercial insurance providers sometimes arrange Medicaid audits on healthcare providers to whom they’re providing coverage.
  • You’re going to need to present a list of all of your submitted Medicaid claims- The biggest and most noteworthy task of addressing an audit is sending your records. Hopefully, your medical records at your facility are very organized and detailed. When you’re sending details on your Medicaid charges, the more information you have the better. Each claim should include information on how much money was paid out by Medicaid on it. As soon as you know you’re being audited, head to your records and take stock of everything. It’s a tedious task, but an audit gives you a great opportunity to organize and to improve your record keeping practices.
  • You should not let your due dates get too close before taking action- Take due dates seriously. You don’t want to appear to be procrastinating or delaying about your audit. If you wait too long to address your audit, the audit contractor responsible for it may take action against you. Be constantly conscious of upcoming audit deadlines so that you don’t overlook an important task or submit a record too late. Also, you should make note of the fact that your due dates are dates before which the recipient must have received the necessary documents. You must account for the time the records will be in the mail to make the due date.
  • You’ll want to meet with a lawyer before you send in any documentation- One of the first steps to resolving a Medicaid audit is typically the Medicaid Provider Questionnaire. This questionnaire will ask some questions about what type of medical service provider you are. You need to take care to leave some response for every single question on the questionnaire. Look over the completed form with your lawyer before you send it in.

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