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Practice leaders want pay for audits that find nothing
6 days ago
1 min read
At MGMA's government affairs town hall on Sept. 29, an Alaska practice leader turned the tables on downcoding audits: if an insurer audits your charts and finds the claims were coded correctly, the insurer should pay for your time. MGMA is shopping draft legislation that would prohibit automatic downcoding by Medicare Advantage plans, with a fallback that permits it only after a plan proves a physician upcoded above a set rate. Much of the burden comes from self-funded ERISA employer plans that sit beyond state regulators' reach, the town hall heard.























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