Checklist on What to Do When Notified of a ZPIC or Medicare Audit and Site Visit - Part 2

Wednesday, April 4, 2012

When a physician, medical group or other healthcare provider receives a notice of an audit and site visit from Medicare, the Medicare Administrative Carrier (MAC) or the Zone Program Integrity Contractor (ZPIC), things happen fast with little opportunity to prepare.  Hopefully this checklist will help you to prepare for the on-site visit that will shortly follow.

Many items on this checklist may seem common sense to the reader;  however, they would not be on here if I did not encounter them as problems in at least two different instances for each one.  This the second part of the checklist.

11. Assign one main staff person as communication point with the auditors (and your attorney).

12. Keep a copy of every document or paper you provide to the auditors during the site visit.

13. Be aware of scrutiny of policies and procedures for narcotics or pain medications.

14. If the records needed by the auditors are in a different office of the practice, don't kill yourself getting them during the site visit.

15. Don't guess at the answers to the questions asked by the auditors.

16. Expect to be asked for your drug list or formulary.

17. Do ask questions of the auditors.

18. Do not voluntarily advise the auditors of suspicions of wrongdoing or ask if what you are doing is correct.

19. Keep good copies of and document your transmittal of documents to the auditors.

20. If additional time is needed, request it by telephone and confirm it in writing.

Although this checklist just scratches the surface of the audit process, I hope you find it of some help in preparing for any upcoming audit involving a site visit.

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