Responding to pre- and post-payment audits

Editor’s note: Amy Inch, COTA, CPC, CPMA, will present “The Other Denials: Prepayment and Post-Payment Review” on day one of the 2024 Revenue Integrity Symposium, which will take place September 12–13 in Oak Brook, Illinois. Kung is the senior director of revenue integrity at Mayo Clinic. Learn more about the event by downloading the brochure. Use NAHRI’s justification letter template as a guide to gain your organization’s support for attending.

Q: What challenge does your session help address? How?

Inch: The session addresses the impact of audit denials on revenue, specifically looking at audit processes, red flags, and what to include in review response documents.

Q: What are you most excited about for this year's conference?

Inch: I am looking forward to expanding my awareness of the revenue cycle challenges and solutions through the expertise and knowledge of both session instructors and conference participants.

Q: What's a great piece of advice you like to give people about your session topic?

Inch: CMS prepayment and post-payment audit denials can have a significant impact on revenue. Healthcare organizations can minimize the impact of reviews through proactive programs ensuring compliance with coverage and regulatory requirements.