Fair Medical Audits

Working toward a fair audit process

PAI has long identified problems associated with medical audits as among the major challenges facing physicians today and has championed the cause for greater transparency and a fairer audit process. PAI has developed a multifaceted advocacy plan designed to address problems faced by physicians in preparing for and responding to medical audits, which include:

• Lack of transparency in the audit process
• Unqualified auditors
• Inaccurate audits, often due to flawed extrapolation formulas
• Recoupment of alleged overpayments before conclusion of the appeal process
• Contingency payments to RAC auditors
• Excessive look-back periods
• Punitive rather than educational focus of many payers and auditors

For more information on PAI efforts in this area, contact Kelly Kenney, PAI Counsel at k2strategiesllc@gmail.com.

Fair Audit Advocacy

 

Learn More

Tools for Physicians

 

Learn More

IMPACT OF AUDITS

To highlight the real life impact of certain audit practices, PAI President and EVP/CEO of the North Carolina Medical Society Robert W. Seligson produced a video, “Guilty until Proven Innocent: When Medicare Audits Cause Casualties,” depicting how an unfair Medicare audit devastated one North Carolina medical practice.