Receiving a request for billing records can be a stressful experience, and if you are unprepared for them, your practice could face recoupments for services already rendered. They could also lead to more scrutiny from government entities and insurance companies. Being accurate and thorough at every step along the way can help you through a current audit, as well as lower the risk of future investigations.
At Dental Auditing Solutions, we understand that payer and government audits can be overwhelming, and our team is here to help you make sense of it all. Missing or incomplete records make up the most common error found in these investigations, so having a guiding hand can be a significant advantage. If you have received records requests from an insurance payer or a government agency like the OIG or the DOJ, talk to our team about your next steps.
Understanding Your Role In Payer Audits
Payer audits are an integral part of our healthcare system, making sure that everyone is above board. These help to make sure that our healthcare costs stay reasonable by seeking out waste and fraud during billing, and while they are a necessary component, payer audits can be stressful for providers.
At DAS, our team is here to help you to navigate the complex world of payer audits. We can review your claims and payments from dental insurance companies in order to ensure that they are accurate, and that they have been filed in the right way. We understand that filing claims is not always the simplest task, so we make things a little bit easier for you during the auditing process.
Government Agencies Also Pay Attention To Your Claims
When filing claims, you need to be accurate, and your commercial payers are not the only ones who are keeping score. Government agencies such as the Office of Inspector General, as well as federal law enforcement such as the Department of Justice and the FBI, want to know that you are following the rules. Medicare and Medicaid also perform audits to ensure that claims are accurate, so as a dental provider, you need to understand what these agencies and organizations require. Keep in mind Medicare and Medicaid have managed care plans administered by commercial payers but that is federal money therefore federal laws may apply.
If you have received notification of a record request, talk to DAS early in the process. Both government and payer audits are important to manage, as they can result in recoupments and more. We can help you by working alongside your team and your healthcare attorneys during a payer investigation or government audit.
Under Audit? Call Dental Auditing Solutions Today!
When insurance companies and government organizations want to dig a little deeper into your claims, our team is here to help. To find out more about how our government and payer auditing services help, give us a call at Dental Auditing Solutions at (972) 459-1508 today!