Member Forum

Medicare audit per CGS of solo Doc

  • 1.  Medicare audit per CGS of solo Doc

    Posted 10-11-2017 05:22
    I have been audited by CGS Medicare carrier and in the appeals process the Nurse Reviewer missed "the # of minutes spent with patient" at the bottom of the clinical sheet. And a few other errors.
    I know there is at least one other solo Fam Med Doc in Ohio being audited. Are any other solo Docs being audited? Or other private practice Docs being audited?​
    If so I am very concerned. If not I wonder if CGS has in their contract that if they can "claw back" any monies they "split the reward" with CMMS?
    I and other Docs with AMA assistance "caught" United healthcare employing an audit company who was compensated for down coding Docs back in late 90's . Is this a repeat by another insurer??
    Feedback please.
    Yes another good reason for DPC style practice.
    Sharonville Family Medicine
    11714 US Rte 42
    Cincinnati, Ohio 45241
    513-769-4951

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    William Sawyer
    dr.will@fuse.net
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