CLAIM AUDITS without Notice

ZPIC IN TEXAS

The Zero Program Integrity Contractor, Health Integrity LLC,
has been auditing providers throughout Texas.

It has been noted that every audit results in a 100% prepayment
audit. Each audit may take up to 120 days or longer before providers will be
returned to normal reimbursement.

HI has decided to go directly to the penalty phase of non compliance
with every provider suffering a 100% prepayment audit while
their audit is in progress.

FYI: HI has other mechanisms available, before 100% prepayment is invoked,
as set forth in CMS guidelines but so far has chosen not to use these procedures.

HI states providers are not considered guilty of fraud and this is a
random audit process.

No information is available as to the internal workings of this audit
process at this time. TAHCS will reach out to this contractor
to better understand the process and report back.

We understand audits range from 1 claim audited while other
providers have received up to 500 audits in less than one week.
Providers claim these audits are excessive and immediately hurt
the cash flow for small business.

Be advised that you may be on 100% prepayment until
HI considers your billing has passed their audit.

If you receive an audit request, it may be wise to call HI and
ask if you are on 100% prepayment audit.
Also, ask how long before you will be released.

HI advises providers they will determine when providers
will be released and no time periods have been given to inquiring providers.

TAHCS advises you comply with the audits while we have our legal counsel
explore possibilities of other action.

If you are audited, please email info@tahcs.org and let us know.
All notifications will be kept confidential by TAHCS.

Meanwhile, join TAHCS today and remember UNITED WE STAND.
We need your participation and membership today.

Go to the web site http://www.tahcs.org/ download your membership application,
fax it back to us with the required information and
enjoy immediate membership
benefits.


Barry Johnson
President TAHCS
http://www.tahcs.org/