Audit Consulting

The CCS training programs are designed to educate practices, guide them through necessary implementation processes and minimize risk of vulnerabilities.  We encourage practices to take a proactive approach and have effective Office and Compliance Policies and Procedures in place.  Risk and vulnerability to a practice can come in many forms which are often unrecognized by practices until an audit occurs.  Proactively implementing and adhering to documented policies and procedures will reduce a practice’s level of risk, such as exposure to error, fraud, waste and abuse related concerns, and others.  However, due to the ever increasing investigative efforts by CMS along with other payors and governing entities, there is no guarantee that a practice won’t be audited.  In fact, it is almost certain that some level of audit will occur.

There are many types of audits that all come with additional susceptibility to healthcare organizations.  When an audit occurs, not only does this cause stress and unrest for healthcare providers but can also pose a significant risk to the financial stability of the healthcare organization itself.

One to multiple of records may be requested in an audit, and in some cases, records may not be requested at all but only a recoupment letter is received.  Due to the varying types and degrees of audits, healthcare organizations often need to seek an attorney as well as a compliance and auditing specialist.  This provides for a better defense for the healthcare organization and much greater chance of handling audit scenarios more efficiently and effectively, as well as potentially minimizing sanctions that may be assessed to providers.

The CCS team of compliance and auditing specialists are experienced in audit management and audit response.  In the event of an audit, our experience and expertise can serve as a powerful tool for healthcare organizations and providers.  The CCS specialists may also work with your attorney if applicable, to provide further assistance and guidance.

Who Can Be Audited

Contrary to popular belief, there is no practice that is not at some level of risk for some type of audit.  Medicare, other 3rd party payors and even state organizations all conduct audits.  Regardless of the type or style of practice, investigations can and do occur.  Providers that operate on a cash-only basis must also comply with requirements.  State organizations regularly conduct audits and assess penalties to both insurance based and cash based practices for non-compliance with local and/or federal guidelines. 

Questions About Audit Consulting

For specific questions or to work with a CCS Audit Consulting specialist, submit your inquiry to our Help Desk.