Click "Show more" below for an interactive video directory. – This presentation by attorneys Christopher E. Brown and Lance O. Leider of The Health Law Firm discusses Medicare and Medicaid audits and fraud. Find out the best practices for protecting yourself and your practice from allegations of fraudulent activity.
00:01 Introduction (Hank Lander)
00:28 Christopher E. Brown Bio (Hank Lander)
01:17 Lance O. Leider Bio (Hank Lander)
02:24 Presentation summary and objectives
03:40 MAC Audits = Medicare Administrative Contractor Audits (Brown)
08:17 RAC Audits = Recovery Audit Contractor Audits (Lieder)
17:09 Prepayment Review (Brown)
17:55 ZPIC Audits = Zone Program Integrity Contractor (Brown & Lieder)
22:50 Responses to all audits and appeals
26:43 Prepare for an audit before it happens
31:04 Checklist for responding to an audit
37:58 Providing records in response to an audit
39:48 Medicaid Audit
44:30 ——————-Questions———————-
45:21 What kind of drugs must be included in an audit checklist?
46:29 What happens when 3rd party vendors get audited and need your information?
47:23 How prolific is auditor malfeasance? (Mitchell Gordon)
49:45 What are the biggest trigger events that cause audits?
51:55 What types of providers are audited most?
52:40 Are ACO's under more scrutiny for audits?
53:47 What are the rights for providers to get paid on past due claims? (Loiue Hilal)
55:24 Would you recommend setting up third party billing review?
57:52 What is the time frame for auditors to reply once an audit starts? (Rodney Douglas)
59:38 Is there any way to recoup costs if your audit comes back negative? (Rodney Douglas)
1:00:59 We are getting requests from 3rd party companies for old records…how should we handle this?

1:02:50 Conclusion & Contact info (Hank Lander)