Medicare and Medicaid officials and contractors are looking to physicians and medical practices to recover funds for those programs. The NCMS has compiled the following resources to assist physicians with understanding medical audits.
General Audit Information
- Medical Audits: What Physicians Need to Know – Physicians Advocacy Institute (PDF)
- What to Do when the Government Comes Knocking – By Michael R. Gordon of K&L Gates LLP (PDF)
- I Think I’m Being Audited! What Should I Do Now? Rose Shattuck, Shattuck Consulting (PDF)
Medicare Audits
Outlines of Appeals Process
- Health Care Provider Reimbursement: Compliance & Enforcement – Chris Brewer, Poyner-Spruill (PDF – 20 pages)
- Medicare Appeals Process – Brochure created by the Medicare Learning Network (CMS)
Helpful Links
Medicaid Audits
Overview
- Program Integrity: Current Fraud & Abuse Initiatives in North Carolina NC Division of Medical Assistance (PDF – 21 pages)
Helpful Links
- NC Division of Medical Assistance (NC DMA)
- NC Department of Justice
