Sidestep 5 High-Risk Behaviors That Heighten MIPS Scrutiny

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article explains common MIPS-related documentation and EHR workflow behaviors that can increase audit risk, with emphasis on fraud, waste, and abuse concerns. It is aimed at providers and practices that participate in MIPS and want a general understanding of risky recordkeeping patterns, audit triggers, and documentation integrity issues.

Why This Topic Matters

Understanding these high-risk behaviors helps MIPS participants reduce the chance of audit escalation and preserve the integrity of supporting documentation. The article is relevant to practices reviewing EHR workflows, clinician attribution, and compliance processes.

What You Will Learn

  • Common documentation and workflow behaviors that may increase MIPS audit scrutiny
  • Why EHR record integrity and attribution matter in compliance reviews
  • How audit risk can arise from data handling, date changes, and measure reporting issues
  • The types of behaviors CMS auditors may view as problematic in MIPS reviews

Who Should Read This

  • MIPS participating clinicians
  • Practice administrators
  • Compliance officers
  • Health information management professionals
  • Medical billing and coding staff

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