Audit

• Targeted Case Management

Top 3 Reasons Targeted Case Management Audits Fail

Targeted Case Management (TCM) audits help ensure that Medicaid services for individuals with serious mental illness or developmental disabilities are medically necessary and meet state and federal requirements. However, these audits can be complicated and require specialized knowledge to navigate. The top three reasons why TCM audits fail are inadequate documentation and record-keeping, inadequate training and supervision of staff, and lack of compliance with regulations and guidelines. This article provides insight into these issues and how to avoid them.

• Audit

TCM Audit Appeals - Part III

In this final part, Part III, to our TCM audits blog, we will address the TCM program audits as conducted by the TCM program at the Department of Health Care Services (DHCS). As written in our previous blogs on this topic, the Targeted Case Management (TCM) program cost reports are audited in California every year. For the program audit (or non-financial), DHCS strives to be on a 3-year. That means that your program may be audited once every 3 years.  

• Audit

TCM Audit Appeals - Part II

As promised, here’s our follow up blog on TCM audits and appeals. Previously in Part I of this series, we noted that every year the Targeted Case Management (TCM) programs and their cost reports are audited in California. The appeals process begins with the informal hearing. If the county does not prevail at this level, it can appeal at the formal level.

• Enhancements

New Feature - Auditor Access

So you just found out your agency is going to be audited. Now what, your wondering? First, take a deep breath and relax. If you’re on UnaCasePro, you got this! If not, well...I feel your pain. 

• Audit

TCM Audit Appeals - Part I

Every year the Targeted Case Management (TCM) programs and their cost reports are audited in California. State Department of Health Services (DHCS) auditors communicate with local governmental agencies (LGA) to obtain financial and other documents for their review. Many LGAs have been taken aback by extensive documentation requests and surprised by the audit findings.