Name: Georgia Medicaid Audit Prep
Uploaded: 2026-10-08T17:00:45.181Z
Duration: 31 min 8 s
Description: Georgia Medicaid Audit Prep

Transcript for "Georgia Medicaid Audit Prep": Alright. Well, hello, everybody, and welcome to today's webinar. We are on a new software for our webinars, and we are so excited. We hope this is just like the last one, but a little bit better. And so we're gonna be going over Georgia Medicaid audit prep. Trevor, are you ready for this? Oh, I'm ready. Alright. So on the agenda today, we have what is reviewed in an audit, what are some Georgia requirements for audits, and then manual check ins and some best practices in documents. And if you need to download any documents, it should be right here in this box right next to us. And, also, our question and answer box is over there. It's a little bit different. You have to hit the q and a tab. So we're gonna test that out real quick. And, Trevor, how do you feel about giving away a $25 gift card to the first person who sends in their name and where they're listening in from today? Yeah. Let's do it. I don't even know why you're asking me. Alright. So y'all can send those in in the q and a. And... Alright. So while y'all are doing that, I'm gonna do a few disclaimers. We have... The first one is just our regular disclaimer where it says the information provided in this webinar is intended for general informational purposes only. While we strive to present accurate and up to date information, the landscape of Medicaid benefits is subject to change, and specific details may vary on state regulations and individual circumstances. If you agree with these disclaimer, please log off now. We also have an audit disclaimer for us as well today. So this information provided in the presentation is intended solely to assist in audit preparation. While every effort has been made to ensure the accuracy and completeness of the information, it is not a substitute for professional advice or legal compliance. We cannot agree that you... We cannot guarantee that you will be fully prepared to pass an audit and use this information at your own risk. And then our last one here today is everything is subject to change with all of the Medicaid fraud, waste, and abuse that's going on right now. The federal government and state requirements are changing every day, so we just wanna let you know that we do know what we have may change, so just so you know. And I think we're gonna pop in our first poll. So the polls are kinda different now. They're going to kinda pulse in this box right here, so you can, look at that. And while y'all answer the poll, we are going to... Let me read the poll real quick. Where are you listening in from today? You can say work, home, or on the go. And while we do that, we're going to do our shout out. So we have... Our winner of the $25 gift card is Angela Bryant from Allison's Place. So, Angela, if you can send us your, email, we will send that over to you. And, Trevor, do you wanna read off some of the other shout outs that we have? Yeah. Let me just figure out how to get this out of full screen here. Let's see here. I think if you just click... Tiffany from. Georgia. Awesome. Cecilia from Smyrna. Jackie from Sugar Hill. Who else in here? Tarmesha. Hello? I know you. You said you said Angela too, I think. Right? Yeah. Alright. Well, we are so excited that y'all are here today, and thank you so much for participating. And we're gonna close this poll now. So it looks like a good amount of you are from working from home or from work, and that's what we do. We work... Alright. So I'm gonna introduce us real quick. My name is Lauren. I am your Georgia specialist here at Geo. And on with me today, I have Trevor Cottey, who is your Georgia agency strategist. So... Hey, Trevor. Hey, Lauren. Alright. So, Trevor, can you tell us a little bit about who Geo is if someone wandered in here today and doesn't know who we are? Absolutely. So GEO is easiest to use software on the market, for all your home care and home health needs, scheduling, EVV, billing, all of the above. Right? But we're also a services company that does Medicaid billing for agencies, VA billing. We provide administrative services. Just try to make you as... Or help you be as successful as possible. Right? Yeah. Thanks, Trevor. We like to call that the geo difference. Alright. So we're gonna jump into the... View and what's usually reviewed in an audit. So an audit can look several different areas of your agency. So I kinda broke it down into, like, the financial side and then the compliance and operations side. So on the financial side, they're gonna look at your balance sheets, your income station, cash flow, accounting records, tax filing, and payroll records. And then for the compliance and operations side, it's gonna be more of your Medicaid requirements, your HIPAA compliance, your licensing and certification, and then missing or inaccurate EVV data. So that's just kind of an overview. We're gonna break more down into this a little bit later, but I just kinda wanted to see where we're going with this. Alright. And, also, in Georgia, they have been known to do virtual audits. So, an audit could not necessarily only happen in person. It can be virtual, so you wanna make sure that you have your paperwork organized instead of time. Maybe have it digital. Confirm what forms of technology you're gonna be using. You may be on Zoom. You could be using your phone to show them around your, agency office. So just know that ahead of time, that way you're prepared and have great Internet connection that is reliable. And then you really wanna make sure that you have key personnel available. If they wanna talk to your administrator or if they wanna talk to your biller, you kinda wanna have those people around. That way, you can, pull them in when you need to. And you also wanna make sure that your documents are easy to locate and provide. So make sure that they're all digital. That way, you can just send them over when they need it. And that's all for virtual audits. Moving into the Georgia requirements. So, they do have a Georgia waiver EVV requirement for audits. So your EVV records should accurately capture important visit information. And I like to always say your EBB record should tell the complete story from start to finish. So you wanna make sure that you have your attendance, your clock in and clock out times, all your client information, the Medicaid ID, your care plan information, waiver type, services provided, all your billing codes is optional, but it is helpful to have on hand as well. That way, if they ask about it, you have it. Alright. So why EVV accuracy matters? It's not just about clogging caregivers in and out. This information connects your clients, your caregivers, your service, your authorizations, and even your billing records. So when information is missing or inaccurate, it can create questions during an audit. You really wanna make sure that you have this consistently throughout your services so your agency is billing correctly. And then our EVV policies and procedures. So I just wanna throw this out there. That way, you know, I'm sure you're all aware of all the policies and procedures, but this is just a little bit of a reminder, that EVV required data, is your service, your client, your carrier birth date, location, start and end time, and accurately captured. Your EVV and billing match, so making sure that your EVV records align with your service documentation and your authorizations, your units, all your claims. And then manual corrections, we're gonna dive a little bit more into this. This can really flag an audit if you are having more of a higher threshold of, manual check ins and check outs. So you really should have supporting documentation explaining why this is happening. And then applicable services. So EDV must be used for services and procedure codes currently required by Georgia Medicaid. And then you wanna make sure that you have your audit documentation. You wanna be able to be able to provide your EBV records, your service notes, your authorization claims, exception reports, and supporting records. Alright. So like I said, you really wanna pay attention to manual check ins, especially, when this happens multiple times. So a manual check-in happens when an administrator checks in a caregiver into a visit instead of a caregiver completing the check-in themselves. And a high level of these can create a compliance, issue and can flag an audit. So your agency should really monitor how many visits require manual intervention, why corrections are happening, which care... Caregiver repeatedly needs assistance, and whether supporting documentation exists. So you really wanna make sure that you have that documentation. That way, you have that in case below 10%. That way, you're kind of above the norm. Alright. And we're moving into our next poll. I just launched it. And it says, do you know what percentage of your visits require manual check ins? So do you know what your manual check-in percentage is? You can answer yes, we track it, or no, we do not track it. And, Trevor, while we wait, can you, tell us a joke? I have a great one I heard last night, actually. Okay. So, Lauren. Alright. Yes. How do you think the unthinkable? How do I think the unthinkable? I don't know. How do you... With an iceberg. Yes. That's very good. I like the the change of your voice there. Thank you. That's funny. Alright. It's looking about 55... 50% on each vote. That's kinda crazy. So, make sure that you are tracking that. That's really important. And moving on. So if you do have a caregiver who is constantly not checking in, you're having to remind them, this is when you have to create a corrective action plan for your manual check ins. And we really, help you take away with this, that you just start implementing this in your agency. So the first step is you wanna set f... So you wanna make sure that your caregivers know exactly how to contact you if this becomes an issue. And then step two, you wanna train your caregivers. You wanna make sure caregivers know exactly how to clock in and out correctly. And then step three, this is when you address the issue, when it keeps coming, an issue, and this is when the corrective action plan comes into place. This is when you're handling those caregivers who are constantly not chalking... Clogging in or clocking out and not following your procedures. So we're gonna kinda dive into how you can kinda implement this. So the implementation of the corrective action plan is the first occurrence is a verbal warning. So you're gonna tell them, hey. You know that these are the following... This is the law. Like, we have to follow this. So you kinda just wanna discuss what's happening, and kinda see if you can help the caregiver when necessary. And then second, you want to do a written warning. So you kinda wanna document that it happened twice. Hey. The second time, I'm going to, write you up. It's gonna be in your file. That way you have this so if the auditor is like, hey. This caregiver is not clocking in a lot. What's the issue? And you're like, I have a corrective action plan. We're working on it. So that way you have the documentation for that. And then if they do have continued issues, this this goes to your agency policy. You kinda... It's up to you on how you wanna do this. We do have a consultant that we talked to, and she's like, if this becomes an issue, you just have to kind of... It's up to you, but I would fire them. And so just kinda making a statement and saying, like, hey. I've warned you multiple times. Like, please, follow these laws. So just kinda up to you on how you want to do a disciplinary action, but that is up to you as well. Alright. So I'm gonna open up our other poll real quick before we move on. And how do you currently store your audit documents? You can say digitally, physical binder, or a mix of both. And, Trevor, while we wait, do you have another joke? I do. And I don't know if you've heard this one before, Lauren, but what do you call a belt made of watches? I don't know. What do you call... A waste of time. Oh, that's pretty good. It's like a waste. I get it. Yeah. That's funny. Alright. It looks like a lot of y'all are saying a mix of both, which I would I would say, yeah, that would make sense. Alright. So moving on to the best practices area. Trevor, can you tell us a little bit about, what they should be doing? Yeah. For sure. So, regular training. Basically, you wanna provide regular training to the... To your staff, right, obviously, on proper clock in and clock out procedures, how to properly document the visits, how to correct mistakes when they do occur. So, like, you know, if there's issues with the, charting, you can go ahead and, get that corrected and, in a in a good way so you have the full chain events. Right? What caregivers should do when technology fails, so if they don't have a signal, phone's dead, you know, something like that, how how do they continue to take notes so that you're protected in the event of an audit, right, when you go in and manually create those visits? And then who should they contact when they need help? Do they reach out to the software company? Do they reach out to you? Is there a specific admin at the agency they should reach out to? Those sort of things. Right? Help you stay well protected in the event of an audit. Yes. And then this is really important too. Make sure your documentation's up to date. I was actually just talking to an agency the other day who was worried about, their caregivers were going in and just copying their preview... Or, actually, it was nurses. They were going in and copying their previous set of notes, and they weren't updating anything. The dates were, like, wrong, saying the person's last bowel movement was a month ago. Right? Oh, gosh. And so to obviously get that corrected because, you know, if an auditor comes and finds something like that, that's just a threat. They're gonna start pulling on that, find everybody else who's having issues like that where you're not keeping good documentation. So really important to keep up to date with all these client forms, licenses, background checks. Right? Because shoot background checks, stuff like that. You got somebody out there who can't even be providing service, you're gonna get in trouble. Right? So, make sure that... I just grab a little screenshot, right, or whatever. Make sure that you, are keeping up to date with all these things, whole idea. Thanks, Trevor. And then how do they perform an internal audit? What should they be looking for? Great question. So, as Lauren has so conveniently documented here for everybody, you know, keep up with your EVV records. Make sure every... All of... Everything that's logged on your EVV records matches what you're billing for. Check on... That goes hand in hand with the next bullet, billing. Right? Your authorizations as well, make sure you're staying within those, not going over a ton, not leaving a bunch of units on the table where the client can end up losing hours. Make sure your care plans are up to date, you know, so that your task list matches what you should be doing. And then, of course, caregiver documentation, licenses, and certifications. We talked about that on the last slide. And then missing signatures. Right? If you're missing signatures from the client or the caregiver, go back and get those. Your your software should be able to let you go back and get those, even after the fact. If it doesn't, give me a call, or get it on paper, right, and attach it to the visit so that you have that, there when the auditor comes. Right? And there are consultants and, people out there who will actually conduct full on audits to your agency for you, if it seems a little overwhelming. Right? And I've got... I know a few. So if that's something you're interested in, just, reach out to me. My contact info will be on this. Alright. And then should they build an audit binder digitally or physically? Great question. I think, I think the answer to this one is, you know, I... I've heard it both ways. Right? I've heard where some people are like, oh, keep everything digital, so that you can access it from anywhere. In the event of a fire, you're not gonna lose everything. Right? Or or flooding of the office. I actually know a lady who that happened to. But then, you know, if your tech goes down and you. have no Internet. or something, the auditor's there, then you can't produce any of the records anyway. So what I personally think seems to be the best way to go about this is, one, your software should be storing everything pretty much automatically already. Right? And then two, I like to go in and pull a full, pull all the digital copies and have them saved not only on my software, but on, like, a physical computer, right, or a hard drive. So that that way, if you do, for some reason, lose Internet when the auditor's there, you can still access all those, on a local drive. Right? And that way, they're also PDF copies. You don't have these massive binders or anything like that, and, you're not using up all your paper, spending all your all your margin on paper and. ink. Right? But I know some people who really prefer the whole binder. Right? And then the auditor comes in and like, here you go. Boom. Put it on. the desk and walk away. But, you know, kinda up to you in that scenario. But, but... Yeah. Alright. Well, now we're moving into more... If you see something, you say something. And if you expect... If you see anything that instances of fraud, waste, or abuse within your agency, you really wanna make sure that you are contacting the relevant parties as soon as you see them. That way you can address and resolve the issue, hopefully, before your agency is experiencing an audit. And you just wanna check-in with your clients regularly, making sure that those caregivers are actually showing up on time and being there. And that way, nothing's going unseen, and you can be confident whenever an audit does happen. And then if you have a signature, you should keep a record of it. Even if it it doesn't... If it's not required, I would still keep it in a binder. If you do have a binder, if you have a digital binder, you can put a folder where it's all just signatures. And that way, you can keep up with all of your required signatures from a client, a caregiver, a physician, a coordinator, or any authorized party that you might be getting signatures from. I would keep ahold of those. That way you can have them stored and they're easy to retrieve. And then also with that, keep all your written communication. We want to make sure that even communication from your caregivers, your administrators, and even your payers. So if there is a disruption in your payment or your billing, and it's because of your payer, you really wanna make sure that you are, checking in with that and you have documentation of this. So if an auditor walks in, he's like, hey. What's going on with this billing issue that happened a couple months ago? You're like, oh, this person didn't pay me, so I had to, like, dispute it and all of these things. So you really wanna make sure that you have that documentation. That way, you can feel good about an auditor walking in. And this can just include any compliance or required task. It can include, through an email, text message, notes, even phone call documentation if you have it transcribed of it, request for corrections, and follow-up communications. You just wanna have a clear paper trail. That way, you you can show what happened, when it happened, and what your agency did about it. Alright. Before we get to this, I'm going to open up another poll, and it says, how confident do you feel about your agency's audit readiness right now? You can answer confident, mostly confident, or not really ready, and that's totally okay. We understand. That's the whole reason we're having this webinar. And, Trevor, do you have a joke while we wait? I do, but they're getting worse as we go. Oh, No. Not not like that. Just bad jokes. Okay. Let me think. How do I deliver it? How do you how do you tell if a tree is a dogwood? I don't know. By its bark. Oh, well, that's actually pretty funny. That reaction is exactly what... That joke should've come. That was funny. I didn't get it at first, and then I was like, oh, okay. I get. it. Alright. It looks like most of y'all are feeling mostly confident, and that's what we wanna hear. We wanna hear that you're... I feel like you would either be, like, super nervous, but still feel a little bit comp... Like, confident. Sorry. Alright. So, our last best practice for you today is to respond to your auditor quickly. You really wanna make sure that you're reading the request fully so you understand what is being asked of you and what's being requested. You can identify every deadline. So if you have a paper calendar or if you have a calendar on your desktop, make sure that you're marking those dates. That way, it'll alert you, before those deadlines. And then you wanna gather your requested records. Use your billing, your audit... I mean, sorry. Use your audit binder or your documentation system that you have set up. Make sure they're all up to date. If you haven't done it for the month, maybe you upload those to get ahead. And then assign responsibilities. Make sure your team knows who is gonna handle each request, and then respond promptly. Don't allow requests or deadlines to sit unanswered. Always answer your auditor right away when you can. Alright. So moving into the documents that you kinda want to keep together, your licenses, your records. So the first kinda section that we're gonna go over is your client forms, your facility license, your carrier license, your background checks for you and your caregivers, and then your personal information as well. And then more on licenses and certifications that you need to include are provider enrollment forms, your completed Medicaid waiver sign up forms, supporting waiver documents, your authorizations, and billing codes. And if you haven't had someone look over your billing codes or your diagnosis codes, we can do that for you today. I have... I'm sharing a tracker right now where you can click into that, and that's where you can book a demo with Trevor. And he will look over all of those things to make sure that you don't have any billing red flags, that won't affect you or cause you to get an audit. So that's just something that you can look into as well. And then don't forget about your compliance documents. This might be the biggest thing. Make sure that you have your prior audit findings, your, risk management plans, your quality assurance plans, and all your HIPAA compliance records. Just don't collect these just when an audit notice arrives. Make sure that you have them organized throughout the year. Do it quarterly, monthly, whatever you feel is necessary. Alright. So we just wanna let you know that we are here for you, and we can check any of your red flags in your billing, kinda what I talked about a little bit earlier. And, Trevor, can you just talk me through a little bit about a billing analysis, what you'll kind of look for for those billing red flags? Yeah. For sure. It's pretty simple prod... Well, simple in theory. Right? But, basically, what we're gonna do is we set up delegate access, in Gammas and in, Telus Mobile Kegerer Plus, not smart, whatever you wanna call it. Right? And we're. gonna go line by line through all of your submitted claims, find any money that might be being left on the table there, or anything that looks off. And then in addition to that, we're gonna go through that aggregator portal, right, your mobile caregiver plus. Find anything that might be stuck in there. There's a few things that can get claims stuck in there before you can even, like, release them. You can find pretty large chunks of money sitting in there. Right? And then we'll also go through, like, your your actual software if you would like, even if it's not geo, and try to find anything that might be stuck in there as well. Whole idea is find you money that hasn't been billed or has been billed and not fully paid out, and identify anything that might cause you a problem down the road in the event of an audit or something like that. Right? And it's free, by the way. Only only way you get charged, right, is if you want us to go get that money for you. Yeah. And so you can click on this fun tracker that goes across your screen, to book a meeting with Trevor or, one of our team members who will help you out and look through your billing for you. Alright. Cool. Across the bottom there, the line. I know it's pretty cool. looks like it looks like breaking news or something. Right? I feel like I'm watching know, ESPN. like, on the news. where it's, like, Yeah. Yeah. blood watch. That's nifty. Yeah. Exactly. Yeah. Alright. But don't just take it from us. Our customers love us, and we'll be right back. Jio has completely turned things around for us. They have been wonderful. Their customer service is outstanding, and our billing has gone way up as well. They're keeping us up to date with all of the changes. They have the information that we need. Even down to keeping up with authorizations, one thing I love about the app, it's like a one stop shop for managing time. And with all the technology that Geo offers, we were able to ensure that we were staffed correctly. We weren't going over units. They're willing to go before their team to bring the results that that you need to grow your business. When you have a competent software company standing behind you and they're knowledgeable, they're efficient, they're always there when you need them, they held your hand every step of the way to make sure that you understand the things that you're doing and and the rationale behind it, the peace of mind is indescribable. Alright. Well, it looks like we don't have any questions today, but, that will be the end for us today. Thank you all so much for coming out, and we will see you in two weeks. So not next week, but the week after. So I hope you all have a great weekend, and bye for now.