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CMA helps develop toolkit for physicians facing medical audits

November 25, 2014
Area(s) of Interest: Licensing & Regulatory Issues Practice Management 


Medical audits are disruptive to physician practices and often cause substantial financial hardship. However, physicians need to consider medical audits as a routine part of their businesses and plan accordingly. There are many actions that physicians can take to mitigate both the risk of being audited and the potential for adverse audit findings in the event of an audit, some of them quite simple.


The California Medical Association worked with the Physicians Advocacy Institute and the American College of Emergency Physicians to develop a toolkit that contains practical tools for physicians facing medical audits. The toolkit provides information and tips to guide physicians in anticipating medical audits, responding to auditors’ requests for medical records and appealing erroneous audit findings. The toolkit also includes detailed information regarding the various types of governmental and private payer audits, appellate procedures and extrapolation methodologies used by some payers to calculate alleged overpayments.


Click here to download the toolkit.


Contact: CMA legal information line, (800) 786-4262 or legalinfo@cmadocs.org.

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