Compliance · 7 min read
How to Prepare for a Medicaid Audit
A pre-audit checklist that lets home care agencies sleep at night, even when the request letter arrives.
Medicaid audits are not random — they target outliers. Stay off the outlier list and respond cleanly when chosen.
Stay off the outlier list Average visit length, manual EVV edits, and billing per beneficiary should be near your peer median. Pull a peer comparison annually.
Pre-audit binder Per claim sampled: assessment, care plan, visit notes, EVV record, caregiver credentials, supervisory visits, and authorization.
Response window Most audits give 14–30 days. Begin pulling charts the same day the letter arrives.
Get help early Agencies that engage a UR consultant within the first week of an audit notice recover 30–60% more dollars.
We perform pre-audit reviews and audit response support.
Helpful resources from AllGrace
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