Washington Healthcare News
Articles, Jobs and Consultants for the Healthcare Professional
Richard S. Cooper. Esq., Member, McDonald Hopkins LLC

Audits – Trends and Action Steps to Mitigate Exposure

By Richard S. Cooper, Esq.
McDonald Hopkins LLC

See all this Month's Articles

Original Publish Date: October 10, 2017

Government and commercial payer audits have increased significantly recently – both in terms of frequency and recoupment amounts requested. Payer audits carry substantial financial exposure and can be very costly to defend. The failure to detect and correct areas of audit exposure and the failure to have an effective audit procedure in place pre-audit can have dire consequences.

Payers are using more aggressive tactics:

Key areas of focus for audits include:

Proper medical record documentation – medical necessity

Documentation action steps

Patient responsibility issues

Take all audits seriously

Be prepared

Audit response process elements

An effective audit response

Mr. Cooper provides legal representation to a broad range of hospitals, other healthcare facilities and physician groups across the United States. He has been listed in The Best Lawyers in America for health law for twenty-three consecutive years and selected for inclusion in Ohio Super Lawyers (2005-2015).

Visit the McDonald Hopkins LLC web site at www.mcdonaldhopkins.com.