Healthcare Defense MAC Audits Lawyers
Along with doctors always having to be concerned about the quality of care they provide to their patients, they must also be knowledgeable about the role of insurance claims within their practice. One of the key aspects of this is Medicare Administrative Contractors, commonly known as MAC. Since the goal of MAC is to make sure no fraud takes place against Medicare, investigators are always on the lookout for discrepancies regarding Medicare payments and any claims that may be false or fraudulent. If you receive word your practice will be the subject of an upcoming MAC audit, take it seriously and immediately contact skilled healthcare defense MAC audits lawyers to provide expert legal advice throughout the process.
Keeping Accurate Records
When your practice is having a MAC audit occur, investigators will be asking for any and all records you have pertaining to billing for Medicare Parts A and B. To make your MAC audit go as smoothly as possible, it is best if you have very accurate records that you can give to investigators from the start. By doing so, you decrease the chances auditors will continue digging into your practice’s financial matters and attempt to make you look guilty. If you are being asked numerous questions by auditors in these situations, do not feel as if you are required to provide these answers on your own. Instead, work with your healthcare defense MAC audits lawyers to craft a careful, detailed, and honest response that will result in a successful outcome.
Auditors Make Mistakes
When MAC auditors arrive at your practice, do not assume they will perform their job perfectly. In fact, it is very common for auditors in these situations to make numerous mistakes. For example, they may incorrectly apply newer regulations to your audit when in fact older regulations were still in place at the time in question. Also, many auditors are eager to wrap up their investigations, and thus will simply jump to conclusions based solely on assumptions rather than facts. Finally, if they are inexperienced or perhaps feel as if they have total control over the finances of your practice, they may overstep their authority. If any of these acts happen, it can have a long-lasting impact on your practice and even your medical career. Rather than let this happen, always have healthcare defense MAC audits lawyers on your side who can carefully oversee the process and make sure you don’t become the victim of an overzealous government investigator.
Audits and Their Consequences
If your practice is under a MAC audit, the consequences could be severe depending on the outcome. For example, if Medicare fraud charges are determined to be true by auditors, your practice may have limited ability to bill for Medicare claims, and may also be forced into a prepayment review that could last at least six months. Also, should an auditor determine your practice made severe mistakes along the way regarding Medicare billing and payments, your practice may find itself being ineligible to participate in federal insurance programs. Should this happen, the financial impact could cripple your practice and force you out of business. Instead of letting the situation spiral out of control, hire healthcare defense MAC audits lawyers immediately upon learning a MAC audit will occur.
Avoiding an Audit
When these situations arise, it is vital to remember that just because you have been informed your practice will be the subject of a MAC audit does not necessarily mean it will ever take place. If you hire knowledgeable healthcare defense MAC audits lawyers quickly enough, they can assess your situation and sometimes prevent government auditors from ever setting foot inside the front door of your medical practice. However, in the event a MAC audit does take place and reaches conclusions you disagree with, your healthcare defense lawyer can advise you on the appeals process and other related matters.
As with any audit, many complexities are involved that require expert guidance from attorneys who handle such cases on a regular basis. If you and your medical practice are preparing to be the subjects of a MAC audit, schedule a consultation with healthcare defense MAC audits lawyers to discuss your situation in more detail.