Medicaid Provider Self-Audits
Providers must conduct a self-audit every two years and repay any overpayments
Overview
In Alaska, Medicaid providers who bill the Department of Health (DOH) for services must do a self-audit every two years. This means they need to check a random sample of claims they submitted for payment, sign and submit a report on the results, and repay all over payments they find.
Who qualifies?
Self-audits must be completed by all enrolled Alaska Medicaid providers who bill DOH for services. This includes assisted living homes, transportation providers, and substance user disorder providers, as well as medical practices.
For more information, see Alaska Statute 47.05.235 and Alaska Administrative Code AAC 160.115.
How to sign up
Due dates
- Self-audits are due once every two years, on December 31
- A calendar year is ready to be audited when at least one year has passed since the end of that year
- A self-audit looks back at just one of the past two calendar years ready to be audited
For example, a self-audit due Dec. 31, 2024, can report on claims billed in 2022 or 2021. It cannot yet look at claims in 2023, because one year needs to pass before you start your review.
Overpayments
If your self-audit finds you have been overpaid:
- DO NOT submit an AK-05 (adjustment/voids form) to Conduent for processing
- Instead, please include a check for the amount of the overpayment made payable to: State of Alaska. This should be submitted with your self-audit or no later than 60 days following submission.
More information
Forms and information about how to do a self-audit are available below:
- Attestation Form
- Provider Self-Audit FAQs
- Provider Self-Audit Checklist
- Suggested Provider Self-Audit Steps
- How to Determine sample size RAT-STATS
- How to Obtain a Valid Random sample RAT-STATS
- Provider Self-Audit Worksheet Explanation
- Provider Self-Audit Worksheet Sample
Please submit provider self-audit reports and attestation, as well as any payments, to:
Department of Health
Medicaid Program Integrity
3601 C Street, Suite 902
Anchorage, AK 99503
