On multiple occasions we hear from a practice that failed an insurance audit and need our help.

They are shocked because they previously passed “an audit.” 

There are two reasons for this. 

Many doctors who think they were audited only had a request for records.  This is not a full audit.   This is where someone back at the payer's office is reviewing the records.

Even if you had a actual audit in your practice more than a year ago, things are very different. 

Audits conducted now are much more thorough than previously.  Most auditors are much more aggressive in finding a reason to deny an exam.

We have been asked, is it true auditors are paid based on what they find.  In some cases payers pay their auditors based on how much money they collect from you!