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Being informed that you will undergo a Medicaid audit is typically very stressful for the average healthcare provider. However, such an audit is a normal, routine occurrence in the operations of a medical facility and does not necessarily indicate that your practice has aroused suspicion.
Your first reaction to receiving notification that you will be undergoing a legal audit is to find experienced legal counsel. An audit requires you to fulfill certain responsibilities that can be time consuming and complicated. It’s best to relegate these duties to an experienced professional and focus on your main job task.
If you meet all of your responsibilities in submitting the appropriate forms and documentation for the audit, you should have no trouble. Legal counsel is of vital importance in being confident that you’ve done everything you need to do to put the audit behind you.
What is the purpose of Medicaid audits?
A Medicaid audit is meant to look out for any fraudulent conduct by healthcare providers when filing claims. During an audit, you will need to show clearly that you have not overcharged the Medicaid program.
One reason why handling audits can be a particularly complicated business is because of all the different contractors out there who are in charge of carrying out these audits. Different contractors often go about the process differently so that a healthcare provider who has dealt with a particular contractor cannot assume the same experience if a future audit comes from a different contractor.
When a contractor handles an audit, they will be looking to recover funds that were unfairly charged to Medicaid. The contractor may have a financial incentive to do so. The best way to cope with audits is to already be doing interior audits organized by your own personnel on a regular basis. If you perform regular interior audits yourself, you’ll be highly familiar with your Medicaid practices and you’ll be more confident that your organization is not guilty of any violations.
The following are some important things you need to know about dealing with a Medicaid procedures at your New Jersey healthcare practice: