Gail Dudley D.O., CHCQM, FAIHQ, MHA, FACOFP

(813) 867-6558

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CMS Audit Tips


How to Survive a CMS Contractor Audit

The Risks to Hospices

1. Hospices are financially vulnerable to CMS contractor audits.
2. The actual provision of care is often not relevant to recovery amounts
3. Recoveries can exceed 7 figures.


The Hospice Provider Survival Process

1. Learn what CMS contractors try to uncover and how they try to find it.
2. Know how to preemptively provide the information contractors seek.
3. Identify both contractor and provider timeline stipulations.
4. Differentiate administrative requirements from other concerns.
5. Understand the importance of certifications and their documentation.

Beginning the Process

1. Contract with a board certificated professional with long-term experience.
2. Involve local staff in this order: management, training staff, general staff.
3. Learn the basics of defensible charting and other documentation.
4. Understand that the security of the business is at stake.


Why You Should Choose Me

1. I am board certified in 4 domains, including Hospice/Palliative Medicine.
2. The actual provision of care is often not relevant to recovery amounts
3. Recoveries can exceed 7 figures.