Why is it difficult for companies to follow CMS directives during retrospective audits?

The challenge companies face in adhering to CMS directives during retrospective audits largely relates to the potential loss of revenue. When companies are subjected to audits, they may discover discrepancies in coding or documentation that could lead to adjustments or reductions in reimbursement. The fear of financial implications often makes entities hesitant to fully comply with audit directives, as they might be apprehensive about revealing issues that could impact their revenue streams.

While billing compliance is indeed a significant concern and can lead to complications during audits, the overarching issue tends to center around financial incentives and the resultant implications for the company. Companies sometimes prioritize their revenue stability over strict adherence to directives, leading to their difficulties in following through with CMS guidelines during audits.