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STATE OF NEW YORK OFFICE OF THE MEDICAID INSPECTOR GENERAL 800 North Pearl Street, 2nd Floor Albany, New York 12204 (518) 4733782 Fax: (518) 4746773 ANDREW M. CUOMO GOVERNORJAMES G. SHEEHAN MEDICAID
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How to fill out audit of claims for

01
Gather all necessary documentation related to the claims
02
Review the claims against the documentation to ensure accuracy
03
Verify the legitimacy of each claim by cross-referencing with supporting evidence
04
Document any discrepancies or issues found during the audit
05
Summarize the findings and recommendations in a report

Who needs audit of claims for?

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Insurance companies
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Healthcare providers
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Government agencies
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The audit of claims is conducted to verify the accuracy and legitimacy of the claims submitted for payment, ensuring compliance with relevant regulations and identifying any potential fraud or discrepancies.
Typically, entities that process claims for payment, such as insurance companies, healthcare providers, and other organizations that handle claims submission, are required to file an audit of claims.
To fill out an audit of claims, you must gather all relevant claim documentation, ensure accuracy in reporting claim details, and follow the specific guidelines provided by the auditing authority to complete the required forms.
The purpose of the audit of claims is to ensure the integrity of the claims process, prevent fraud, ensure regulatory compliance, and maintain the accuracy of financial reporting.
Reported information typically includes details about the claims submitted, payment amounts, relevant dates, provider information, and any discrepancies or issues identified during the audit.
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