OIG Audit Prevention & Survival

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OIG work plan generated audits and Medicare prepayment reviews are rolling out across the country. In fact, your practice could be next. Although scary, they actually aren’t a big deal – if you’re prepared. But, if you face an OIG audit or prepayment review unprepared, you could end up paying hefty penalties and fines based on a variety of avoidable violations.

Your only OIG defense is a proactive plan. There are specific steps you can take to reduce your chances of being audited. And if you do get audited, you can get through it unscathed. The trick, you must know what the OIG is looking for and why.

So how can you figure out what the OIG’s focusing on? The answer, The OIG Work Plan.

Each year the Agency produces a work plan that outlines their goals and their focus for the upcoming year. It is long, and hard to interpret even for veteran healthcare professionals. So even if you have the time to wade through this publicly available document, finding the information you need is no easy task. But there is a way to get the information you need, and know how to use it without giving up your nights and weekends.

Sonda Kunzi, CPC, CPC-H, CPPM, CPMA, CPC-I has done the work for you. She has analyzed the OIG Work Plan and identified items that will have the highest impact on your practice. She is presenting her findings at a recorded online training session. And in addition to presenting the actual facts, Sonda will be tell you specifically what you can do with the information to reduce your risk of an audit.

>Here are just a few of the benefits and practical, how-to tactics you’ll receive by attending Sonda’s upcoming online session:

1. Incorporate OIG 2015 audit focuses into your internal reviews to significantly reduce your risk
2. Proven policies and procedures to bolster the strength of your records
3. Get the inside scoop on Medicare scrutinized CPT codes and avoid costly errors
4. Master OIG auditing practices, and communications and radically improve your outcomes
5. Implement proven, effective internal testing practices to audit-proof your records
6. Protect yourself with proven documentation strategies for Medicare Pre-Payments
7. And so much more…

It’s essential that you are “on watch” and stay up-to-date on the latest coding and coding practices being targeted by the OIG. It is the only way you can take prophylactic actions to stay off of the OIG radar, which is ultimately the goal.

Next year, the OIG’s budget is a massive $400 million. And a good portion of that money is dedicated to expanding the Health Care Fraud Prevention and Enforcement Action Team (HEAT). Taking a proactive approach is the only way for you to head off or overcome attention.

Meet Your Expert

Sonda Kunzi
CPC, CPC-H, CPMA, CPPM
CPC-I
Coding Advantage, LLC

With more than 20 years of experience in healthcare, Sonda’s expertise includes comprehensive knowledge of ICD9 and CPT coding concepts, documentation and training, and medical insurance reimbursement.

Her experience comes from working in a variety of positions both as an outside consultant and as a professional within hospital-owned and private medical practices. Sonda’s background includes serving as compliance officer and liaison for JCAHO standards in an ambulatory care setting.

In addition to practical hands on experience, Sonda also teaches ICD-10 CM/PCS and Advance Coding at Lakeland Community College in Kirtland, Ohio. Sonda is a Certified Professional Coder (CPC), Certified Professional Coder- Outpatient Hospital (CPC-H) Certified Professional Medical Auditor (CPMA), Certified Physician Practice Manager (CPPM), an AAPC approved coding instructor (CPC-I) and AHIMA approved trainer for ICD-10 CM.