Catherine Boerner (cboerner@boernerconsultingllc.com) is President at Boerner Consulting, LLC in New Berlin, WI.
As everyone works to comply with the 60-day repayment rule and, as applicable, the 6-year look-back, it is important that your statistical sampling is accurate. It is worth the effort on the front end of any audit to clearly lay out an audit plan to guide the process while you are focused on the issue at hand. It is also worth the effort on the front end to work with your IT department and business office to pull in all the appropriate data fields to create a reliable report of your billing data to choose the sample of claims from. I have found time and time again that this can be the most frustrating part of the whole process, and it may take several attempts to get it right. It is worth the effort, and everyone learns in the process to make it easier to get accurate claims data reports in the future.
