Audit Methodologies

The Centers for Medicare and Medicaid Services uses a number of different methodologies to audit their services. Search “CMS audit tools.” Evaluate the results. Are they what you expected?

Pick one methodology and write a 2 page paper on the selected methodology. Then perform a full personal audit of the tool and determine if there are any areas that could use improvement. Use at least 1 reference with APA formatting.

Solution Preview

One type of methodology used by CMS in checking compliance is probe methodology. The probe usually targets particular services.Once you meet the specific set guidelines, then the auditors review your claims form before payment is made to reduce any fraudulent claim. The auditor might make a request for additional information, and one must comply and avail the information required. Failure to comply means that you will not be reimbursed for the amount you are claiming.

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