Healthcare Audit

What happens in a Medicare audit A Medicare audit is a review process conducted to ensure that healthcare providers comply with Medicare's rules and regulations, including billing practices, patient care, and documentation standards. Here’s what typically happens during a Medicare audit: Notification: The provider receives a notice from Medicare or…

Defending a Pharmacy Benefit Manager (PBM) audit involves several key steps to ensure compliance, accuracy, and proper documentation. Here are the steps to effectively defend a PBM audit: 1. Preparation and Organization Document Management: Ensure all pharmacy records, including prescriptions, invoices, and patient information, are well-organized and easily accessible. Audit…