A state medical services office improves its Promoting Interoperability (PI) program

Challenge 

A state medical services office needed to assess post-payment audit services for their Promoting Interoperability (PI) program and verify that federal funds were distributed and used appropriately. The requirements included performing post-payment audits of eligible professionals and hospitals that received an incentive payment as a part of the program. 

Solution 

BerryDunn’s government assurance team: 

• Performed a risk assessment to identify and understand provider risks.  
• Conducted Adopt, Implement, and Upgrade (AIU) and Meaningful Use (MU) desk audits and provider field audits to help identify compliance vulnerabilities. 
• Developed program training for stakeholders to help reduce provider failure rate. 
• Conducted hospital eligibility and MU audits and verified payment calculations.  

Outcome

BerryDunn’s audit process provided the medical services office with the clarity they needed, understanding that federal and state funds are being used appropriately and provider payments for the program are being properly monitored and controlled. The improvements have led to a decrease in provider failure rate in the program.