Medical practices require physicians to care for patients while also managing basic business operations. This dual role requires a need to balance patient care with administrative responsibilities, such as managing finances, overseeing staff, and ensuring compliance with healthcare regulations. The complexity of these demands can lead to challenges, which can inadvertently trigger audits.
One of the most common errors that can trigger an audit is noncompliance with applicable regulations resulting in billing errors. Errors in billing and coding can lead to significant financial and legal repercussions. This is a concern for anyone within the healthcare industry, from small private practices to large healthcare operations. Those who find themselves facing an audit are wise to know how to proceed to mitigate the damage. The following steps can help.
Step 1: Prepare documentation
Proper preparation can streamline the process and demonstrate compliance. Conduct a thorough review of all patient records and billing documents. Ensure they are complete and accurate. It is also helpful to organize documentation systematically. This makes it easier to retrieve necessary information during the audit.
Proper documentation not only facilitates a smoother audit process but also showcases your commitment to maintaining high standards within your practice.
Step 2: Determine what to do on your own and what is best delegated to professionals
When a patient needs medical care, they go to a physician with experience with their illness or injury. The same is true when dealing with legal matters like an audit. There are certain things the medical professionals can prepare on their own, such as the documentation noted above, and others that are best left to the professionals. An attorney with experience in this niche area of law can review the situation and tailor a response to the specifics of your case, better ensuring a more favorable outcome.
Facing an audit in Texas requires a strategic approach. By understanding audit triggers, preparing documentation, and engaging with professionals, your medical practice can mitigate the impact of the investigation.
Attorney John Rivas is responsible for this communication.