Why Were WCM Audits not Held in the Initial Months of the Pandemic When Codes Were Changing Constantly, While Even Medicare Placed a Hold on Their Audits?

While the billing compliance activity did not come to a halt, the activity level was reduced in 2020. The reviews that were performed provided the institution with the awareness that billing integrity was being preserved during the dynamic and challenges associated with the pandemic. Also keep in mind that payers have the right to audit claims retrospectively and because they may have stopped doing so for a period in 2020, the services submitted during that time could still be subject to a retrospective review.