Answering the door: How to respond to government regulators
October 15, 2006
By Paul Cirel
When regulators come knocking, the most common type of contact is a notice of audit.
Just like there is no such thing as a routine traffic stop, there is no such thing as a routine audit. When CMS (the Center for Medicare and Medicaid Services) or the OIG (Office Inspector General) or DMA (Division of Medical Assistance) sends a request for certain patients’ medical records, the provider should assume there is a common denominator to those claims that leads the government to suspect fraud or abuse.
A knock on the door: What do government regulators want from providers?
October 15, 2006
By Paul Cirel
Not many days go by that I don’t hear from a health care provider who has just been contacted – or worse yet, visited – by government agents, demanding the production of medical charts, billing and payment ledgers, appointment books and/or every other sort of record that providers regularly maintain.
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