We Help Hospitals & Practices Undergoing CMS QPP/ MIPS Audits & Appeals
- Initial phone conference within 24 hours of contact
- Communication with staff to understand the status of the current Audit or Appeal
- Immediate review of all communication between the relevant hospital or practice and auditor
- Immediate review of all documentation submitted as part of Attestation
- Review of your system’s Audit Trails if Required and Requesting Additional Documentation From Vendors if Required to pass the Audit/ Appeal
- Develop, author, and submit the audit/appeal based on best strategy and strongest possible defense
All eligible professionals (EPs), eligible hospitals (EHs), and critical access hospitals (CAHs) attesting QPP/ MIPS may be subject to an audit both pre and post positive payment adjustment.
Since 25% of participants will be audited as part of the Quality Payment Program. We can help you prevent or help you handle an audit or appeal. Research has shown 50% of providers fail their Security Risk Analysis required to submit under the Advancing Care Information (ACI) section of MIPS. This is why many clinics have worked with us to complete this since it is not worth facing a -4%, -5%, -7% and/or -9% payment adjustment in future years since our work has passed random audits by CMS auditors (ie Figliozzi).
In order to withstand a potential audit the proper documentation needs to be available to support the attestation. It is important to save the proper documentation before attestation. Otherwise, we can work to try and recover it through your audit trails. If you are worried you are not compliant, we can provide a Mock Audit by completing an in-depth assessment and identify any gaps to assist in mitigation prior to an attestation.