Under the current payer environment, providers have greater risk for audits of all types. The Medicare Program alone completes at least five potential forms of audit on rehabilitation claims:
- Medical Unlikely Edits (MUE's)
- Medical Review (MR) - completed by the MCA/FI
- Comprehensive Error Rate Testing (CERT) Program
- Recovery Audit Contractor (RAC) Review
- National Correct Coding Initiative (NCCI) Edits
Images & Associates is prepared to assist you with completion of an internal audit to determine how well you meet the requirements of audit with a particular focus on correct billing and documentation of Medical Necessity.
If you have experienced an audit that has resulted in repayment to the Medicare program, we will assist you in managing the appeals process - a process that can take up to a year to complete. Our track record for successful appeals is over 85%.
AUDIT RISK ASSESSMENT & DENIAL MANAGEMENT