A paid claim can still carry audit risk if the file can’t prove it. CMS reported a 6.12% Medicaid improper-payment rate for FY 2025, with 77.17% traced to insufficient documentation. This article on Medicaid billing audit findings gives a five-point self-diagnostic to run on five recent claims, a 24 to 48 hour record-retrieval drill, and notes on how extrapolation can widen exposure.
https://ltcpro.us/common-medicaid-billing-mistakes-that-cost-your-facility-thousands/
https://ltcpro.us/common-medicaid-billing-mistakes-that-cost-your-facility-thousands/
A paid claim can still carry audit risk if the file can’t prove it. CMS reported a 6.12% Medicaid improper-payment rate for FY 2025, with 77.17% traced to insufficient documentation. This article on Medicaid billing audit findings gives a five-point self-diagnostic to run on five recent claims, a 24 to 48 hour record-retrieval drill, and notes on how extrapolation can widen exposure.
https://ltcpro.us/common-medicaid-billing-mistakes-that-cost-your-facility-thousands/
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