Per CMS rule, an eligible professional (EP), eligible hospital, or critical access hospital (CAH) attesting to receive an incentive payment for either the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program may be subject to an audit.
We at Phoenix Healthcare Advisors, LLC can help you handle an audit.
Pre- and Post-Payment Audits
Medicare providers may be subject to pre-payment audits. These pre-payment audits will include random audits, as well as audits that target suspicious or anomalous data. Providers selected for pre-payment audits will request supporting documentation to validate submitted attestation data before releasing payment.
Providers selected for post-payment audits will also be required to submit supporting documentation to validate their submitted attestation data.
- Engagement Letter: Providers selected for an audit will receive an initial request letter from the auditor.
- Information Request List: A list will be attached to the engagement letter outlining all required documentation from CEHRT.
- Documentation Submission: The engagement letter will outline methods of submission and a deadline for submitting the required documentation.
- Review Process: The initial review process will be conducted at the audit contractor’s location, using the information received from the initial request letter.
- Audit Determination: Once the audit is concluded, the provider will receive an Audit Determination Letter from the audit contractor.
For inquiries and other concerns, please contact us today so we can help you.