Toolkit for Physicians Facing Medical Audits



The TMA worked with the Physicians Advocacy Institute and the American College of Emergency Physicians to develop a toolkit that contains practical tools for physicians facing medical audits. The Toolkit for Physicians Facing Medical Audits provides practical information and tips to help physicians anticipate medical audits, respond to auditors’ requests for medical records, and appeal erroneous audit findings. It includes detailed information regarding topics related to medical audits, including the various types of governmental and private payer audits, appellate procedures, and extrapolation methodologies used by some payers to calculate alleged over-payments.

 

  • Medical Audits: Top Ten Tips for Physicians to Anticipate, Respond and Protect Their Practices
  • PowerPoint: Tips for Physicians Facing Private Payer and Governmental Audits
  • Checklist for Physicians Responding to Requests for Medical Records
  • Checklist for Physicians Appealing Audit Findings
  • PAI White Paper: Medical Audits: What Physicians Need to Know (updated)
  • ACEP resource: Preparing for Physician Audits
  • ACEP resource: The Significance and Implications of the Delay in the Assignment of ALJs in Medicare Part B Appeals

Medical Audit Toolkit