Practice Management Alert

Question: I hear so many horror stories about billing offices that fall apart and make disastrous mistakes when there is an unannounced audit from a federal regulator or fraud unit. How can I prepare my staff so that we don't crash and burn when - and if - such auditors ever come knocking at our door?

Billing Office Manager in South Carolina
 
Answer: The best way to prepare for any audit is to conduct your own periodic internal audits so you can be confident your office is billing appropriately.
 
But your staff should also understand how they should behave when they encounter someone from a "fraud unit," "investigation unit" or "medical review." Sometimes such reviewers create a false sense of security by saying things like "I'm just doing a quick investigation - don't worry about me and I'll be out of your hair soon" or "I'm just here to look at things, so don't get upset." Staff should be educated on the practice's policies for an unannounced audit. Despite the reviewer's seemingly casual attitude, the audit is a serious event that could cost the practice money and even lead to fines or other disciplinary actions.
 
Train your staff to notify the billing manager and practice management immediately when an auditor unexpectedly shows up or contacts your office and notifies you of an impending audit. In the event of an impending audit, you'll have time to find out as much as you can about the potential problem and even resolve it early in the game. Consider involving your attorney early, before the problem becomes an official action that is much harder and expensive to resolve.