TCORS’s Director of Medicaid Services, James Wietrak and Medicaid Audit and Compliance Coordinator, Denise Smith, held a seminar on the Medicaid audit process for Connecticut Association of Optometrists (CAO) members on September 18 in Wallingford, Connecticut.
The seminar will cover a detailed discussion of the Department of Social Services’ Medicaid audit process; a discussion of the Connecticut General Statutes that cover the audit process; an explanation of the sampling and extrapolation methodology used by DSS; the audit reporting process; and the audit appeal process. In addition, there will be a discussion of some current audit findings and disallowances effecting optometrists and suggestions on how to avoid audit disallowances.
In addition to helping providers and institutions navigate the Medicaid audit process, TCORS also provides periodic record reviews, assistance during the audit process and will represent your organization during an audit appeal.
Prior to joining the firm, James was the Acting Deputy Commissioner of the Department of Social Services. As such, he was responsible for the operations of the Department of Social Services Bureau of Administration. From 1993 to 2009, James was the Director of Quality Assurance. He directed audits of Medicaid providers, directed recipient and provider fraud prevention and detection activities.
Prior to joining the firm, Denise worked at L&M Medical Group as the Coding and Compliance Coordinator. She was responsible for conducting medical record documentation audits, overseeing the payor audits and supplying education and feedback to her billing staff and providers. Denise was also a member of the ICD-10 implementation core team, which was responsible for overseeing both provider and coder education for ICD-10.
