The New Era of Audits: An AI-driven Future

As I was preparing for a recent presentation on audits, I found myself reviewing the usual data, denial rates, updated numbers, and top reasons claims are denied. Was the spinal brace denial rate still as high as last year? Were documentation errors still leading the pack? You know the drill.

But in the middle of it all, a thought hit me: I’ve been presenting on audits for 15 years, and I remember how I used to describe the audit process: A Medicare office with ten auditors and stacks of patient charts piled high, each one flipping through the pages looking for one mistake, one missing note, one incorrect modifier so they could stamp DENIED on that claim and move on.