Surviving Audits in Hospice

No one wants to hear the dreaded words, “you’re being audited”. What exactly is an audit and why would you be chosen for one? Do not panic, there could be a simple explanation.


What is an Audit? 

An audit is an inspection of an individual or an organization’s financial accounts. The Centers for Medicare & Medicaid Services (CMS) hire unified program integrity contractors  (UPICs) to audit and investigate home health agencies. A UPIC may send a letter requesting documents, call, or show up to your business unannounced to ask for the records in question. If you are unsure that they are really UPIC employees, ask to see their badges. 


Why Would a Hospice be Chosen for an Audit? 

Incomplete or inadequate documentation could be a reason your hospice would be audited. CMS often treats issues such as longer lengths of stay, live discharges, and recertification of a patient for hospice as red flags, possibly triggering an audit. There has been an increase in compliance deficiencies in hospice, so CMS is being extra vigilant. 


How to be Audit Proof 

Document everything. It is as simple as that. Using real-time data, record everything your employees have done. You must have a record of care that matches the billing for it. The best way to do this is by implementing a software that can do it all for you. The best hospice EMRs are capable of documenting, recording, and billing in a snap. They track signatures, all care given, have a place to record notes for each visit, and process claims using all of that data. Follow the mantra “if it wasn’t documented, it wasn’t done”. 


Choose Elara EMR

Elara was designed by nurses to provide services specifically for hospice and palliative care. It has all the features you could ask for and more. Become audit proof, reports can be pulled in minutes. Elara can save you money, is affordable, complaint, accessible, and offers a free trial. Check out Elara, you have nothing to lose!