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Self-Audits to Avoid Civil Monetary Penalties

A Self-Audit Can Help Mitigate 43 C.F.R. 1003 Civil Monetary Penalties

1–Initial Consultation

Establish baseline on case, number of claims, and codes involved.   Flat rate quote.

2–Selection of Claims

Claims are selected by code as a whole or in a sample.    

3–Analysis & Documentation

Assemble all information regarding the statistical extrapolation.

Barraclough NY LLC

New York, NY 10022

Tel: (212) 758-1296.

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Do you want to win your Medicare or Medicaid Appeal? Do you have any questions on how to get started with this process? Then we want to talk with you.  Please use the Contact form and let us help you win.

4–Methodology

Complete documentation on the methodology for submission along with findings.

5–CPA Certification

Optional CPA Certification further confirms the credibility and validity of the audit.

6–Brief to Attorney

Brief attorney on initial findings; review strengths and weaknesses of case; pick litigation strategy.

7–Report (2 versions)

Report of findings.  A second report contains detailed annotations and notes for attorney.

Flate-Rate Pricing – CPA Certification

42 C.F.R. Section 1003 provides Civil Monetary Penalties of as much as 3x the overpayment.    The penalties can be reduced if you have conducted a self-audit "in a timely manner" and paid back the wrong claims.    

We provide flat-rate pricing on a per-claim basis, and have the option to obtain CPA certification (required in some states).  Audits can be on either all claims or on a quality statistical sample performed by our experts.

"When the provider has performed a Self-Audit, it mitigates the amount of Civil Monetary Penalty."

8–Pleading Support

Preparation of draft pleadings for mitigation for the Office of Inspector General (OIG).