Audit Adjustment and Dispute Resolution

Audit adjustment and dispute resolution begins with proper report preparation. We begin our cost reports by reviewing prior year adjustments and identifying areas that we may agree upon so that we can incorporate those items if the current year report. We then submit the cost report with complete supporting documentation for most amounts reported so that the MAC or audit contractor can clearly follow the audit trail included in the supporting documentation. This streamlines the desk review process and decreases the likelihood of field audit.

Depending on the scope of the audit and needs of the provider, we can attend any audit in person or be available by telephone. We review any proposed adjustments and calculate expected impact on payment. If we disagree with any adjustments, we gather additional documentation and put forth our position in writing citing all applicable regulations and PRRB decisions. If the proposed adjustment is not reversed, we will then analyze the merits of our position to determine if a cost report re-opening or appeal is more appropriate.

We can also perform legal support services or expert witness testimony in a variety of disputes.