Hospitals, doctors preparing for expanded Medicare audits - Nashville Business Journal:

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“You can put two codin g experts in the same roomand they’lp disagree over what was appropriate to use,” he If audited, providers have 45 days to submit completed claims records, which can includes individual patient charts. Providers and supplierds who are found to have received an overpaymeny can file an appeal or agred to the charges and arrangefor payment. If they choosed the latter, they have the optionn of writing a check or having a financiaol intermediary withhold future Medicare payments until the debtis repaid. Appealing a federap audit can take as long as two yearsw and entail significantlegal fees, says David vice president of finance for the .
“Even if you win, it can put quit a burden on the hospitals,” he Individual appeals can cost up to McLure says. Under the program, audi contractors can request up to 200 records every 45 eachof which, if contested, wouldr require its own appeal. According to Medicare and Medicai statistics, about 4 percent of providerse inthe three-year trial programm filed an appeal. Of those, one thirrd got a ruling in their favor.