Medicare Financial Management Manual (Pub. 100-06), Ch. 8 § 60.1.2
Audit Confirmation Letter (a.k.a. Engagement Letter) - In-
60.1.2 – Audit Confirmation Letter (a.k.a. Engagement Letter) - In-
House Audit
(Rev. 107, Issued: 09-22-06; Effective: 10-01-06; Implementation: 10-02-06)
The in-house audit confirmation letter should give a minimum of 4 weeks and a
maximum of 6 weeks notice of the contractor’s intent to conduct an in-house audit (see
Exhibit II in §170 of this chapter for a sample letter). The engagement letter should be
provider-specific and must include the following:
• Identification of the major areas the contractor will review.
• A list of the required documents and the due date that provider must send copies
of the documentation to the contractor. The provider should be given at least 3
weeks to provide the requested documents, and the due date should be at least a
week prior to the telephone entrance conference.
• Date and time of the telephone entrance conference. (Enclose the telephone
entrance conference agenda – Exhibit III in §170 of this chapter).
• A request that the provider assign a contact person to be the audit liaison.
• A tentative pre-exit telephone conference date should be set within a week of the
anticipated completion date of all audit review work. (Enclose the pre-exit
conference format – Exhibit V in §170 of this chapter).
• Notice that a telephone exit conference will be conducted once all audit
adjustments are finalized.
• Notice to the provider that all documentation and records requested must be given
to you in a timely manner and that failure to produce documentation will result in
non-negotiable audit adjustments.
Notice to the provider that, as a general rule, you will not honor any reopening requests
for the “lack of documentation” adjustments. This policy has no impact on the normal
provider appeal rights with the Provider Reimbursement Review Board.