Could a seemingly innocent conversation between you or your office staff and a Manitoba Health auditor get you in serious trouble? Unfortunately, the answer is yes.
It is not unusual to hear how, during the course of a physician audit, Audits and Investigations (A & I) has expanded its investigation and demanded repayment of a large sum of money based on information acquired during a conversation with the physician or his/her billing staff.
This information has often been obtained during what appeared to be an innocent communication in which the physician or billing staff was attempting to be helpful and cooperative. However, such communications may result in the inadvertent disclosure of information that is used by A & I to broaden its investigation, initiate an investigation of the physician’s colleagues and/or demand an even larger repayment amount.
To avoid these “fishing expeditions” and the potential disclosure of unhelpful information, Doctors Manitoba recommends that physicians instruct their billing staff not to communicate directly with A & I. All communication with A & I should go through Doctors Manitoba.
Where a physician chooses to represent himself/herself when audited, care must be used when providing information. Only provide A & I the information that it has specifically requested, nothing more.
Even if you believe you have nothing to hide, you’d be surprised what a vigourous auditor (usually a former police officer) may latch onto.
Updated: November 2016