Did you know, if an agency is able to submit 20-30 compliant claims one after another, and bring their risk below 15%, CMS is required to drop their survey?
Using a lawyer to focus on the appeal, is only part of the solution. Agencies will only survive if they stop the practices triggering audit first!
Typically, agencies believe they were “randomly chosen” and they are being “picked on” by CMS. This is not the case, CMS uses data mining, patterning, and complex algorithms to determine audit targets. Every OASIS your agency submits is immediately analyzed by CMS OperaCare levels the playing field, by allowing your agency to use computer analysis before your claim goes to CMS. By going through the OperaCare process while under audit, your agency will be able to drop its risk to under 15%, forcing CMS to drop their survey and ultimately re-start payment of claims.