Healthcare fraud audits are becoming more aggressive, more data-driven, and far more expensive for medical practices that are unprepared. Federal agencies, Medicare contractors, Medicaid Integrity Programs, and commercial payers are dramatically increasing their oversight efforts — and even minor billing, coding, documentation, or compliance mistakes can trigger devastating financial consequences.

Today’s healthcare audits go far beyond random claim reviews. Auditors are increasingly using advanced analytics and AI-driven monitoring tools to identify billing irregularities, documentation inconsistencies, utilization trends, and reimbursement patterns that may suggest fraud, waste, or abuse concerns.

Unfortunately, many practices unknowingly expose themselves to risk through:

• incomplete documentation,
• improper coding,
• lack of internal auditing,
• weak compliance oversight,
• inconsistent policies,
• poor staff training, and
• inadequate responses to payer requests.

Even small issues can quickly escalate into:

• overpayment demands,
• payment suspensions,
• extrapolated recoupments,
• civil penalties,
• False Claims Act exposure,
• exclusion from federal healthcare programs,
• or full-scale investigations.

In this practical, real-world training, healthcare attorney Amanda Waesch, Esq., will provide actionable strategies to help your organization reduce audit triggers, strengthen compliance safeguards, respond effectively to audit requests, and better protect your reimbursement.

You’ll learn how auditors identify targets, which compliance weaknesses most often attract scrutiny, and what proactive steps your practice should take now to minimize exposure before an audit occurs.

In This Training, You’ll Learn How To:

• Identify the most common billing, coding, and documentation issues that trigger healthcare fraud audits
• Understand the difference between fraud, waste, abuse, overpayments, and simple billing errors
• Reduce high-risk compliance vulnerabilities before they attract payer scrutiny
• Recognize emerging audit trends impacting physician practices, clinics, and healthcare organizations
• Prepare internal documentation and compliance processes to withstand audit review
• Conduct effective internal audits to identify problems early
• Respond appropriately to audit notices, medical record requests, and payer investigations
• Avoid common mistakes that worsen audit findings and increase repayment demands
• Develop corrective action plans that demonstrate good-faith compliance efforts
• Create stronger staff accountability and reporting procedures
• Understand the financial and legal consequences tied to False Claims Act violations, Stark Law risks, and Anti-Kickback concerns
• Protect your organization from costly recoupments, penalties, and reputational harm

Why This Training Matters

Government agencies and commercial payers are aggressively expanding audit and enforcement efforts across the healthcare industry. Recent federal initiatives have increased the use of advanced technology and AI to detect suspicious billing activity and identify organizations for deeper investigation.

At the same time, healthcare organizations are facing growing pressure to demonstrate strong internal compliance programs, effective Fraud, Waste, and Abuse oversight, and proactive audit readiness.

Practices that fail to prepare may face:

• major repayment demands,
• operational disruption,
• payer contract risks,
• increased audit frequency,
• legal exposure,
• and long-term financial damage.

This training provides practical, plain-English guidance to help you reduce risk, strengthen compliance defenses, and confidently navigate today’s increasingly aggressive audit environment.

Who Should Attend?

•  Practice Administrators
• Physicians & Providers
• Compliance Officers
• Medical Billers & Coders
• Revenue Cycle Leaders
• Office Managers
• Healthcare Executives
• Internal Audit Staff
• Compliance Committee Members
• Anyone responsible for billing, coding, or compliance oversight