Reimbursement Audit-Defense (C)

Medicare and Medicaid agencies (ZPIC, MAC, RAC, CERT, PERM and more) have dramatically increased the volume and frequency of pre-/post-pay audits. “Audit defense” has become a complex, multi-disciplinary process that adds to the administrative-burden facing providers.  This program will explain how third-party auditors develop and monitor the SNF “Profile” based on reimbursement patterns, and teach facilities how to assess their risk areas.  The presenter will explain current audit trends and common reasons for denial, and provide guidelines for streamlining the facility’s audit-response system to strengthen audit outcomes.