Are you ready for your MEDICAID AUDIT!?!


If you haven’t heard yet, Medicaid is performing audits all over the country and they’re already in the Southeast.  We know just reading those words will stress you out so we thought we’d pass along what we’ve heard as well as a few tips from folks who’ve already gone through this exercise.

What we’ve been told is that Medicaid’s focus will be on a random four month sampling of invoices from a three year period looking specifically at ancillary medical supplies.  According to our sources ancillary has been defined as those supplies and services that are directly identifiable to an individual patient, furnished at the direction of a physician because of special medical needs and are either not reusable, represent a cost for each preparation or are complex medical equipment.  This four month random sample will then be analyzed by the auditors to find charges that should have been billed to other payer sources before it was billed to Medicaid.  That number will then be extrapolated to a three year grand total which will then be disallowed.

Your first question should be how can I combat this?  Unless you’re using a patient charge tracking software package and a Part B billing service you’ll have to do A LOT of leg work.  You’ll have to provide proof that the charges in question were both used and billed properly by comparing them to the resident charts.

A better way to combat this is to use Grove .  Allow us to provide Tracer, our patient charge and inventory tracking software and accredited Part B billing services FREE of CHARGE.   Tracer is a very well-rounded and easy-to-use software package that can also provide all the documentation and reporting you’ll need to make the audit process MUCH less painful.  We can also take care of your Part B billing for Wound Care, Ostomy, Trach and Enteral patients under our provider number.  This service is also offered at no charge to you for both the service and products not to mention our clinical support from our certified Clinical Nurse Consultant team.

We want to make sure that you view us as a resource and not just as a vendor.  That’s why our focus is on being the best medical supply partner to the long-term care industry by providing quality medical supplies and innovative services at competitive prices.  Contact us today to discuss how Grove can help you protect your organization and increase your bottom line.  There’s no sense in fighting this battle alone!

The Healthcare Note by Grove Medical

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3 responses to “Are you ready for your MEDICAID AUDIT!?!

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