Learn more about Medbill’s Audit Assist Services here. And your staff is alerted to any claims that may be missing documentation or might be susceptible to an audit. They will ensure the claims are reviewed for Policy Compliance. The Medbill DME Billers team can review ALL claims before they are sent to the Payor. Becoming and staying prepared in the event of a UPIC audit can make a world of difference. Stay Educated with Medbill’s AssistanceĪn essential part of any audit is preparation. Remember preventing mistakes upfront is a much faster and easier solution than correcting the errors after they occur. This process should outline and educate everyone on the records management procedures. Have an education process set up for new employees and even have a “refresher” course for all employees. Keep yourself and your staff educated on Medicare’s coding and billing requirements. If you fail to provide a timely response for requested documentation, it could result in suspension from participating in the Medicare program.
#UPIC U CHICAGO MAC#
To learn more read our article, “Are you Prepared for DME MAC Contractor Audits?” Who is at Risk for an Audit? Selecting prepayment and post-payment medical review functions.Refer suspected fraud and abuse to the UPIC.The Medicare Administrative Contractor (MAC) is in charge of all other responsibilities assigned to the UPIC by the Statement of Work.
Medicare Administrative Contractor’s Working with UPIC Takes Resources Away from Othersīoth fraud and abuse diminish the Medicare Trust Fund resources for others who need it. This results in wasted costs and improper payments. AbuseĪbuse is when a person or company’s actions are not acceptable with sound medical, business, or fiscal practices. This can include personal benefit, someone else’s benefit, or a company/organization. Fraudįraud is purposely misleading other people or facts for specific reasons. Since UPIC audits search for fraud and abuse, it’s essential to understand the difference between them. The UPIC uses the above and additional techniques to identify Medicare and Medicaid program weaknesses and vulnerabilities. Perform regional Medicare and Medicaid data analysis.The Centers for Medicare and Medicaid Services (CMS) created the UPIC audits to identify and stop fraud and abuse in Medicare and Medicaid. Unified Program Integrity Contractors (UPIC) Audits Goal Medicare regulation is an extensive program, and being prepared before an audit can save you time and resources. Durable Medical Equipment (DME) suppliers should be prepared and ready for a Unified Program Integrity Contractors (UPIC) audit.
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