Comparative Billing Reports

Self-Audit Help

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.