Tips for Effectively Responding to SMRC Audits

This article discusses the complexities of medical audits, especially in responding to Medicare and insurance audits. A medical audit evaluates compliance with payer guidelines when submitting claims for medical services, including documentation, coding, and billing practices of healthcare providers and facilities. Different audit types include those by Medicare Administrative Contractors (MACs), Office of Inspector General (OIG), Recovery Audit Contractors (RACs), Supplemental Medical Review Contractors (SMRCs), and Unified Program Integrity Contractors (UPICs), each with distinct focuses and processes.

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