Guest Blog: Preparing Yourself To Get Through An Audit Unscathed

I wasn’t born and raised in Florida, but in the 15 years that I have called Jacksonville home, I have come to appreciate the charms and nuances of living in a beautiful subtropical climate where living near water brings with it natural beauty as well as the potential for disaster.

As most Floridians are keenly aware, hurricane season extends from June 1 until Nov. 1. Fall is here and another hurricane season has nearly reached its conclusion, which means we are almost ready to breathe another collective “Sunshine State sigh of relief,” having gotten through another year unscathed.

However, there is another serious storm that is building, one that threatens the wound care world unlike anything we have seen to date.

Preparedness in readying for a hurricane can mean the difference between life and death. Readying yourself for an audit by the Centers for Medicare and Medicaid Services (CMS) or a recovery audit contractor (RAC) can mean the difference between your financial survival and the ability to continue delivering your infinitely valuable services to those in need. The key is to be proactive versus reactive.

If you do not think you will ever come under a pre-payment review or audit, whether due to the odds or your belief that you are innocent of any practice patterns that could be found as fraudulent, think again. Going through a Medicare pre-payment review a few years ago for the primary sin of providing wound care services to homebound patients was an experience that is still tinged with bitterness.

In my opinion as an editorial board member for Today’s Wound Clinic, I believe the August 2012 edition of our journal is required reading and is the most important issue of the publication we've printed to date. You can read about my experiences in a wound care pre-payment review that lasted over a year in the article “Signs of an Impending Audit: Are You Waving Red Flags?” (https://todayswoundclinic.com/articles/signs-impending-audit-are-you-wav…)

The entire issue is dedicated to becoming proactive in surviving a wound care audit. Even if you provide wound care services as an adjunctive service, do not think you are immune to financially incentivized RAC auditors whose sole mission is to recoup money from as far back as 3 years ago. Imagine going into a restaurant 3 years after eating a meal and demanding your money back, and having the federal government encouraging you to do so. It sounds preposterous, but unfortunately this is reality.

Please follow the other links listed below to several articles in our August edition, which covers various topics related to auditing. These articles will serve as important references in better understanding the issues, what is at stake, and how we may all be impacted in wound care.

www.todayswoundclinic.com/articles/coming-audit-storm
www.todayswoundclinic.com/articles/abcs-wound-care-auditing

As a colleague and friend, I can only wish you never end up in the crosshairs of a CMS or RAC audit of any kind, and once again I ask you to read the recommended articles.