Auditing/Compliance Tips & Resources

 

You Have the Power to Prevent Fraud, Waste, and Abuse

The Office of Inspector General (OIG) makes it as easy as the click of a button to report fraud, waste, abuse, and mismanagement in the U.S. Department of Health & Human Services' programs. Through the OIG Hotline Operations' “Report Fraud" link, they accepts tips and complaints from all sources ...

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OIG Continues to Focus on POS Errors, and So Should You

POS errors are more than “clerical.” As the work plan explains, “Medicare pays a physician a higher amount when a service is performed in a nonfacility setting, such as a physician's office, than it does when the service is performed in a hospital outpatient department or, with certain exceptions, in an ambulatory surgical center...

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Understanding the Multiple Procedure Rule

When providers report more than a single (non-evaluation and management) procedure during a single encounter, payers typically will reimburse only the highest-valued procedure at full fee schedule value, and will reduce payment for the second and subsequent procedures ...

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