While every provider of the Medicare program is a candidate for an audit, typically, the UPIC audit selection is based on consumer complaints or data analysis. A consumer complaint comes from the company’s employees or the beneficiaries.

Meanwhile, data analysis will search for a large number or mix of cases. Those cases will involve patients who’ve received hospice care, stayed in acute care facilities or had extended home visits.

Learn more about how Armory Hill Advocates helped a pain management client that had a UPIC audit.  

The Centers for Medicare and Medicaid Services (CMS) created the UPIC (formerly ZPIC) audit to identify and stop fraud and abuse in Medicare and Medicaid.

The main goal of a UPIC is to help CMS:

• Find fraud, abuse, and waste
• Perform regional Medicare and Medicaid data analysis
• Complaint resolution
• Investigate suspected fraudulent activities

The UPIC uses the above and additional techniques to identify Medicare and Medicaid program weaknesses and vulnerabilities.

Learn more about how Armory Hill Advocates has helped clients that have had a UPIC audit.