Meaningful Use Audits

We Help Hospitals & Practices Undergoing CMS EHR Meaningful Use Audits & Appeals

What do I need to do to avoid a potential audit?

I received an audit engagement letter. What do I do?

We can help you prevent or help you handle an audit.

In order to withstand a potential audit the proper documentation needs to be available to support the attestation. It is important to save the proper documentation before attestation.  If you are worried you are not compliant, we can provide a Mock Audit by completing an in-depth assessment and identify any gaps to assist in mitigation prior to an audit.

Our highly skilled consultants have a knowledge of the meaningful use audit and appeals process and timely response rates to meet your deadline:

• Initial phone conference within 12 hours of contact
• Communication with staff to understand the status of the current audit
• Immediate review of all communication between the relevant hospital or practice and auditor
• Develop, author, and submit the audit/appeal based on best strategy and strongest possible defense
• Lead your staff in every step of the process

All eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) attesting to receive an incentive payment for either the Medicare or Medicaid Electronic Health Record (EHR) Incentive Program may be subject to an audit both pre-and post payment.  

In addition to the post-payment audits that have been conducted since 2012, CMS began pre-payment audits, starting with attestations submitted during and after January 2013. CMS has also gone on record saying that at a minimum, 5% -10% of EHR Incentive Program participants will be audited.

CMS Resource links for Eligible Professionals (EPs) and Eligible Hospitals (EHs) participating in the EHR Incentive Program are as follows:

• Supporting Documentation for Audit
• Sample Audit Letter for EPs
• Sample Audit Letter for Eligible Hospitals & CAHs
• Audit Overview Fact Sheet
• Medicare EHR Incentive Program Return Payment/Withdrawal Form
• Eligible Hospital Appeal Filing Request
• Eligible Professional Appeal Filing Request

CMS is taking the potential for fraud in the meaningful use program seriously.  If you are aware of significant issues with an already submitted attestation or have received an audit engagement letter from CMS and its contractor Figlozzi and Company, EHR Meaningful Use Audit Team, or a State performing a Medicaid Audit we can help you.  Call us at 847-322-0139 or email us at vanessarose@ehrpmc.com

• How do I Prepare for an Audit?
• Who is Selected for an Audit?
• How Can a Provider Avoid An Audit?
• How is a Provider Notified he/she will be Audited?
• What Documentation is Needed in An Audit?
• What are Steps in Audit Process?
• What are Audit Best Practices?
• How Do I Help Avoid An Audit?
• What is the Appeals Process?
• What is a Mock Audit?
• Should I do a Mock Audit?
• What are Common Mistakes Made During Attestation?
• Who typically gets audited and what is considered suspicious data?
• What are common reasons providers fail the audit process?
• Why do the Majority of Meaningful Use audits fail based on simple Yes/No Measures than the more complex numerator / denominator based measures?
• What is Another Possible Way to Fail An Audit in 2015?