266 words / 1 min read / For practicing physicians

Several members have received audit letters about their billing from the government’s Comptrollership and Compliance Unit (CCU) in the last few weeks regarding physician fee-for-service billings. 

WE CAN HELP: Please let us know if you receive an audit letter from the CCU. We can offer advice on preparing your response and, if there are challenges in gathering patient records, we can obtain a reasonable extension of time for you to respond. This support is included with your DRMB membership.

WHAT HAPPENS NEXT: The CCU will then return with ​“Preliminary Audit Findings,” often many months or even years later, and we can help prepare a narrative response on your behalf. It is helpful to us, too, as we continue to track the CCU’s activity including which tariffs are most often challenged and which physicians are most likely to be selected for an audit.

The CCU has agreed that copies of patient records can be sent to them electronically or physically for most audits, without the need for an auditor to attend at your practice. Their electronic portal is secure and PHIA-compliant.

OF NOTE: Most audit files are ultimately resolved with no repayment or only a modest repayment (often less than $300) required. The CCU has agreed to permit the substitution of lesser tariffs (i.e. Tariff 8509 for Tariff 8529) where appropriate.

THE BOTTOM LINE: If you receive an audit letter or have any questions about the process, please contact Andrew Swan, General Counsel by email at aswan@​doctorsmanitoba.​ca or by phone at985-5860. More information is available on audits in our Managing Your Practice guide.