Prepare your medical practice for CMS audits

A recent statistic reveals that one in twenty practices that have attested for MU will face an audit. And that most practices are most likely to face pre-payment audits. The increased governmental scrutiny can catch practices off-guard. Several hospitals maintain a ‘Book of evidence’ in case auditors come knocking by.

Attesting for Meaningful Use is not enough! Medical practices should ensure they can face audits head-on and have the requisite medical documentation.

Tips to become audit ready!

• Always be ready! The best to insulate your practice from audits and fines is to be prepared. Always save the electronic documentation that supports your attestation. Save the documentation that has the values you entered in the Attestation Module for Clinical Quality Measures. Also, ensure that your payment calculations are carefully documented.

• Your primary documentation includes the time period of the report, the denominators and numerators for the CQMs and evidence that it was created for that particular EP, hospital or medical center. Additional documentation includes a clear review of medical records. And documents to prove and support each measure attested for.

• Most providers make the mistake of hating CMS auditors with a vengeance! It is important to comply with audit requests promptly. Providers should have pertinent document in hand after they receive the initial request letter from the contractor. Providing sketchy documents and one line statements will do more harm than good. Detailed, precise and evidence based documentation is required.

• Medical care providers should stop being backseat drivers. Relying on admin staff or practice managers too much can be a risky proposition. Physicians should stay in the loop, verify documentation, analyze medical care records and medication lists. It is mandatory for every physician to make sure their patient records are accurate. As the slant is on evidence based care there is no better person than physicians to verify the veracity of documents.

• Is your EHR certified? Receive documentation from the vendor stating that they are CHERT certified. The Office of the National Coordinator maintains a list of certified EHR products. Monitor upgrades and verify that your system meets evolving guidelines and measures. Get a copy of the licensing agreement with your vendor to submit to the auditors.

• Conduct a thorough security risk assessment of your medical practice. Check if your practice is compliant with the existing security regulations. Not conducting an extensive security risk assessment periodically, can trip you up when the auditors reach your practice.

Is all these tips helpful for you? Tell us how your prepared for Meaningful Use Audits?