Provider Self-Audit Resources
This page is dedicated to providing self-audit resources to Medicaid providers. There are three items included here. The first is a Florida Medicaid Self-Audit Guidance document. It is a non-binding document offered to provide guidance about self-audits. The second document is a provider self-audit worksheet explanation (a Word document) and the third is the self-audit worksheet (an Excel document). These last two documents are intended as a resource only and are in an editable format. If you use the documents, please be sure to amend the worksheet explanation to provide details (explanation) for any items on the worksheet. The version here, on our website, is designed to offer guidance about the type of information we need to validate a self-audit. If the information is not helpful, you do not need to use it.
Self-audits may be voluntary (unsolicited by our offices), or in response to a request from our offices or another office with the Agency to consider doing a self-audit to repay overpayments and avoid sanctions and investigative costs.
Medicaid providers have an obligation to ensure that claims submitted to the Medicaid program are proper. When a provider determines that reimbursements were in excess of the amount due from the Medicaid program, the provider is obligated to return the improper amounts to the state. Providers should return the improper amounts to the Agency along with supporting information that will allow MPI to validate the overpayment amount. Examples and an explanation of the necessary supporting information are set forth in the Florida Medicaid Self-audit Guidance.
Self-Audit Guidance
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117 kB
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Provider Self-Audit Worksheet Explanation
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16.5 kB
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Provider Self-Audit Worksheet
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21.2 kB
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