The Supplemental Medical Review Contractor (SMRC) recently announced an audit of excess diabetic testing supplies with service dates between January 1 and June 30, 2019. That’s not the interesting part.
The interesting part is that this audit may have significant implications for the referring physician.
If the auditor is not satisfied with the medical records during the supplier audit, the SMRC will proceed to the referring practitioner’s claims for the express purpose of assessing the underlying evaluation and management services. In other words, missing or deficient medical records in the supplier audit may suggest unsupportable practitioner claims.
The reliance on medical records is not new. The recognition, however, that suppliers are not the only ones accountable for deficient practitioner records is.
The good news is that the larger scope combined with good communication between suppliers and practitioners should go a long way in securing medical records that properly support claims for excess units of diabetic testing suppliers.
On the other hand, poor supplier intake and/or audit response practices can create unnecessary hassle for referring practitioners. The ill-will created if a referral source is targeted because the supplier simply did not submit medical records with their own audit response is a sure way to jeopardize the business relationship.
If you have any questions, ask us directly at the 2020 Look Ahead for DME Suppliers!
The interesting part is that this audit may have significant implications for the referring physician.
If the auditor is not satisfied with the medical records during the supplier audit, the SMRC will proceed to the referring practitioner’s claims for the express purpose of assessing the underlying evaluation and management services. In other words, missing or deficient medical records in the supplier audit may suggest unsupportable practitioner claims.
The reliance on medical records is not new. The recognition, however, that suppliers are not the only ones accountable for deficient practitioner records is.
The good news is that the larger scope combined with good communication between suppliers and practitioners should go a long way in securing medical records that properly support claims for excess units of diabetic testing suppliers.
On the other hand, poor supplier intake and/or audit response practices can create unnecessary hassle for referring practitioners. The ill-will created if a referral source is targeted because the supplier simply did not submit medical records with their own audit response is a sure way to jeopardize the business relationship.
If you have any questions, ask us directly at the 2020 Look Ahead for DME Suppliers!
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