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Ophthalmology and Optometry Coding Alert

Audits:

Prepare Your Practice for 5 Common Audit Types

Published on Tue Jun 05, 2012

Avoid RAC trap for bilateral surgeries. If it seems like audits are coming at your ophthalmology practice from all directions, it's because they are. You need to have your records ready for any of the different auditors who can request them for various purposes. Read on for the scoop on getting ready for four types of Medicare audits, as well as Health Insurance Portability and accountability Act (HIPAA) audits under the Office for Civil Rights (OCR) program to assess privacy and security. 1. Medicare Administrative Contractor (MAC) Your MAC processes claims and can perform pre-payment and post-payment reviews. If your MAC identifies you for an audit, it will send you an Automated Development System (ADS) letter, typically asking you to submit specific documentation. Important: Be sure to review both the front and back of the ADS letter to ensure that you send all of the claim documentation to the MAC. [...]
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