Medicare Audits: A Survival Guide for Skilled Nursing Facilities

Reduce the fear of an impending audit and take a proactive approach to preparedness. Medicare Audits: A Survival Guide for Skilled Nursing Facilities provides detailed guidance on the various Medicare audits SNFs face. Author Maureen McCarthy, RN, BS RAC-MT, CQP-MT, breaks down RAC, MAC, and ZPIC audits; CERT reviews; and more. Detailed descriptions, case studies, and example scenarios provide readers with the tools to understand how to prepare for each phase of an audit and what to expect once the audit is over.
This book will help facilities:

• Gain a comprehensive understanding of the agencies responsible for conducting Medicare audits
• Grasp the processes and steps taken by auditors
• Conduct an internal audit with the provided checklists
• Learn their specific risk areas and vulnerabilities
• Understand where to focus internal compliance efforts and controls

Contents include:
Chapter 1: Medicare Oversight of Skilled Nursing Facilities 
Chapter 2: Medical Review Audits 
Chapter 3: Recovery Audit Contractor Audits 
Chapter 4: Benefit Integrity Audits 
Chapter 5: Comprehensive Error Rate Testing Program 
Chapter 6: Department of Health and Human Services/Office of Inspector General 
Chapter 7: Medicare Advantage Plans 
Chapter 8: Case Studies and Scenarios
Chapter 9: Preparing Your Facility for an Audit 
Chapter 10: Post-Audit Processes 

2016, HCPro