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The Electronic Health Record Incentive Program was started in 2011, when it was determined that the process of transitioning to the use of certified electronic reporting technology would move along much faster if incentives were offered to those who took the initiative to learn the process.  However, the CMS also had to have a defense system in place to prevent false reporting or ineligible payments being made.

If a provider within your hospital or medical center has filed to receive EHR (Electronic Health Record) incentives via the Medicare or Medicaid EHR Incentive Program, then there is a chance that an audit could be executed by CMS (Center for Medicare and Medicaid Services).  There are several things that should be done to ensure that an audit is smooth and painless.

  1. Ensure that all documentation related to the EHR Incentive Program – electronic and hardcopy – is saved and filed in case it should be requested in an audit. According to the CMS guidelines, this information should be kept on file for a minimum of six (6) years.
  2. The hospital or medical facility should retain any information supporting their payment calculations. This will serve as proof, during the audit process, that the incentive payments made were correct.
  3. The audit may be performed by the CMS if the provider is eligible to receive Medicare or dual-eligible payments. A state or contractors hired by the state will perform the audit if the provider received Medicaid payments. Be aware of who you will be dealing with and correspond accordingly.

There can be negative outcomes if the correct documentation cannot be provided to auditors.  You can get help from professionals, who can help walk you through the audit process.  If you do not handle this process correctly, the hospital or provider may be required to payback all monies earned as a result of EHR Incentive Program payments.  Fortunately, you are provided time to get your documentation in order, and to seek the help of the professionals, if you need that support.  The facility or provider will be alerted to the impending audit by mail.

Contact us today for Auditing for EHR Incentive Payments!


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