decisionhealth Newsletters, Part B News - 1999 Issue 7 (July)
9 tips on how to respond to E/M prepay audits: Don't panic, organize
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Article Overview
This article explains how medical practices can respond to E/M prepay audit requests from carriers. It focuses on preparation, organizing supporting records, deciding when to involve counsel, and communicating with the payer while an audit is underway. The discussion is aimed at billing administrators, practice managers, consultants, and physicians who handle claims reviews and audit notices.
Why This Topic Matters
Prepay audit requests can delay payment and trigger broader claims review if a response is incomplete or poorly organized. Understanding the common workflow and documentation themes helps practices assess whether the article is relevant to their audit-response process.
What You Will Learn
- How practices typically respond when a prepayment audit notice arrives
- What kinds of documentation are discussed as part of audit support
- When practices may consider involving legal counsel
- How carriers may review claims and request records
- Why organization and timely follow-up matter during an audit response
Who Should Read This
- Physicians
- Billing administrators
- Practice managers
- Coding professionals
- Healthcare consultants
- Healthcare attorneys
Codes Discussed
Code Ranges Discussed
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