July 2019 Client Newsletter

MIPS audits are here: What you need to know

Beginning this month, CMS will conduct data validation and audits of a select number of MIPS-eligible clinicians for performance years 2017 and 2018. Practices targeted will receive a request for information from CMS' contractor “Guidehouse” via certified mail or email. Those selected for audit will have 45 days from the date of the notice to provide the requested information.

As with any audit, we strongly advise clients to comply with their requests.  Failure to do so will likely set up Medicare withholding your future payments.  

I would be interested in following the process if any of our clients do receive such an audit.

ABN’s – Advanced Beneficiary Notices

As we have written before, properly worded ABN’s for Medicare patients will allow you to be paid by patients for services that are usually covered, but are not in a particular case.  If you need more information about ABN’s, give Rich a call.

Two important points:  They are not valid if the patient is under duress.  If you are going to use one, also be sure to have it signed prior to providing the service.  They are not valid if signed later.