Audits are never fun! In fact, we can all share a common disdain for auditors. But it is a process that keeps everything in check and makes sure that we are meeting the Meaningful Use criteria for optometrists. As awful as audits are, it is possible to make sure that the process goes smoothly. We’ve come up with a list of tips to help you prepare in the event your practice gets audited.
3 Steps to Meet Audit Requirements and Meaningful Use Criteria for Optometrists
There are two types of audits that you could possibly face: pre and post payment audits. Pre-payment audits have only recently become available, and are done before payments have been received. Post-payment audits occur only after a payment has been made, and may include repayments towards the government.
The Center for Medicare and Medicaid Services (CMS) audits between 5-10% of the documents they receive. Most audits are triggered automatically and are not necessarily the result of suspicious activity. However, there are numerous pre-payment edit checks built into the EHR Incentive Programs' systems to detect inaccuracies in eligibility, reporting, and payment. Auditors also look out for practices that intentionally transcribe lower and less complicated codes.
As long as you have complied with the requirements of the program, there is no need to worry. The CMS hires contractors to perform the audits, so there is a chance that yours does not specialize in the eyecare industry, and can come to incorrect conclusions. If you truly feel that they’ve made a mistake, don’t be afraid to challenge it. You should also seek assistance from your state association about the process and you might find colleagues in the industry who’ve been through an audit with the same auditor.
The audit notification will come in a form of a letter in the mail. If you receive that dreaded letter, the first thing to prepare is your paperwork. The letter will state the list of documentation required. Standard items requested include proof of your certified EHR, proof of attestation screenshots, records from your EHR vendors, and CQM reports.
Do not delay compliance and send all documentation as soon as possible. But make sure that you do not alter any records you send in! You are allowed deadline extensions, but make sure that they are approved by your auditor. Your practice should also appoint a facilitator who will maintain contact with the auditor. While going through your attestation, if you realize that you have indeed entered in wrong information; you can withdraw your attestation.
Follow Best Practices
Stage 2 of Meaningful Use began earlier this year, and since the reporting period for 2014 is 90 Days for both stages, you might receive your incentive payment as early as this year. If you weren’t audited for Stage 1, you’re not clear for Stage 2. Your practice should still be prepared, and implement best practices.
Be obsessive about documenting everything – screenshots serve as great proofs. You should also keep documentation for 6 years after attestation. It is also important to conduct an internal audit every 6-12 months. It’s better to catch your own mistake before someone else does! Your internal audit should include making sure that each physician’s charts are up-to-date with correct record keeping, finding out if accurate choices of codes were used, taking the time to go through all patient records, and making sure that the reasons for patient visits are accurately stated on file. You might receive your incentive payment as early as this year. If you weren’t audited for Stage 1, you’re not clear for Stage 2. Your practice should still be prepared, and implement best practices.
Meaningful Use is a complicated topic, and it’s even harder when you have to go through an audit. For more information about Stage 1 of Meaningful Use and audits, download our eBook!