Author Description

Medicare Audits in Long-Term Care: A Guide to MACs, RACs, and ZPICs Wayne van Halem, AHFI, CFE, President Cutting-edge strategies to prepare and respond to Medicare auditsKnow what to expect during a long-term care Medicare audit The book Medicare Audits in Long-Term Care: A Guide to MACs, RACs, and ZPICs describes the different types of Medicare audits that nursing homes face and helps you take a proactive approach to audit preparedness. You also receive detailed descriptions of what you can expect during the different types of Medicare audits, how to conduct an internal audit, specific ways to prepare for an audit, and what to do once you have been audited. This resource helps you: Gain a comprehensive understanding of the agencies responsible for conducting Medicare audits Grasp the processes and steps an auditor takes so you know what to expect and can be prepared Conduct an internal audit with the internal audit checklists provided Learn specific risk areas and vulnerabilities that may be present in your facility Understand where to focus internal efforts and controls as is relates to compliance Table of Contents Chapter 1: Medicare Oversight of Skilled Nursing Facilities Chapter 2: Medical Review Audits Chapter 3: Recovery Audit Contractor Audits Chapter 4: Benefit Integrity Audits Chapter 5: Comprehensive Error Rate Testing Program Chapter 6: Department of Health and Human Services / Office of Inspector General Chapter 7: Medicare Advantage Plans Chapter 8: Audit Case Examples Chapter 9: Preparing your Facility for an Audit Chapter 10: Post Audit Processes Tools & Checklists