How long will a provider be reviewed on a post-service, prepayment audit (PPM Audit)?
The above answer is correct, but vague. It is a nine month period, but we have helped providers get off who have been stuck on the audit for as long as three years, if you don’t reach an adequate quality level of documentation practices during your first nine months then you will receive a notice that your Special Claims Review – Post Service Pre-payment Audit (SCR – PPM) action will be continued for another 9 month period. On average our providers are released in less than 6 months, the earliest typically being 3 months. This is accomplished through very comrehensive staff trainings, solid systems\protocol development and support from Equitable Solutions staff.
If you would like to learn more please check out what others are saying:
“Damian is extremely knowledgeable and passionate in the work he does. He takes his work seriously with pride and high integrity. His knowledge in the profession of health care, specificially with Adult Health Day Care is superior than any other consultants I have hired. I respect him as an individual as well as a consultant who has such a great sense of humor, sense of responsibility and is detail-oriented, a problem solver and works as a team to complete tasks in a timely manner.” February 26, 2010
Kym Vo ADHC Program Director
Please call 916-247-5959 or visit http://www.SpecialClaimsReview.com
A. DHCS evaluates the need for continuation or modification of a PPM Audit during the standard nine-month audit period. DHCS sends written notice and instructions to providers before the PPM begins and after it ends. Improper claiming discovered by the PPM Audit may result in other actions being taken against a provider.
Related Questions
- Who can a provider talk to for questions concerning post-service, prepayment audit (PPM Audit) documentation requirements for specific claims?
- Who can a provider talk to for other questions concerning the post-service, prepayment audit (PPM Audit) process?
- How long will a provider be reviewed on a post-service, prepayment audit (PPM Audit)?
