Comparative Billing Reports are provided to the provider and supplier community as an educational and informative resource. The reports are intended to assist providers and suppliers in performing self-audits of both procedures and billing practices. The links below provide high-level instruction and advice on how to begin the self-audit process.
CMS Resources: https://www.cms.gov/
• Self-Audit Snapshot: https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Downloads/ebulletins-self-audit.pdf
• Provider Self Audit Change Request R425PI (CR) 7851 briefly describes CMS’s policy on provider self-audits: http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/downloads/R425PI.pdf
OIG Resources: https://oig.hhs.gov/
• Voluntary compliance program guidelines for various segments of the health care industry: https://oig.hhs.gov/compliance/compliance-guidance/
• General compliance educational materials: http://oig.hhs.gov/compliance/101/index.asp
Providers and suppliers should contact the Medicare Administrative Contractor (MAC) for their geographic area for assistance with questions about a specific claim, documentation requirements, and billing and coding questions.
