Fast Break: Medicare Audits

ZPIC. RAC. UPIC. MIC. These terms may conjure up feelings of dread for Medicare providers. These program integrity contractors are responsible for identifying and recovering improper payments in the Medicare program, but they often try to recover proper payments as well.These contractors, in addition to their post-payment audit activities, are now implementing targeted prospective audits, levying suspensions and pre-payment reviews when they identify a “data aberrance.”

Learn more about the Medicare audit and appeals process and ways to mitigate the risk and impact of an unfavorable audit.

Topics will include:

• How are audits triggered?
• The Medicare audit process
• Big "E" – Extrapolation
• Overpayment demand: now what?
• Tips for risk mitigation and audit avoidance