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November 2007
 2007 North Carolina DMH/DD/SAS Community Support Services Medicaid Audits
During provider audits conducted in 2007, the North Carolina Department
of Department of Health and Human Services determined that many providers
received Medicaid reimbursements for poorly documented or unnecessary
services. Audit problems ranged from clerical errors to instances where
consumer received services they did not need.
The results are posted for 178 providers. Audit questions included the
following:
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Is there a valid service order for the service?
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Is the service plan current with the date of
service?
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Does the service plan identify the type of
service?
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Is the documentation signed?
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Does the service note reflect the purpose of
contact?
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Does the service note relate to the individuals
service plan?
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Are the service notes in the service plan?
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Do the units billed match the duration of the
service?
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Does the documentation reflect treatment?
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Was an authorization in place covering this
date?
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OPEN MINDS