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Medicare Compliance & Reimbursement

COMPLIANCE:

Spot Potential Fraud On Your Provider's Claims? Check Documentation, Then Contact Provider

Published on Sun Oct 25, 2009

Examine claims for odd activity, experts say. With compliance in the spotlight, many coders are on high alert. Read on for solid advice on what to do if you encounter a questionable claim. President Obama has made it a priority to curtail Medicare fraud, and major media outlets including 60 Minutes have recently profiled this growing problem. The increased attention on staying compliant has caused medical coders across the country to check and double-check their physicians' documentation to detect issues. How Can You Recognize Fraud? The Office of Inspector General (OIG) has issued scores of documents that profile the types of fraud that they are investigating. For instance, earlier this year, the OIG released its "Health Care Fraud and Abuse Control Program Annual Report for FY 2008." For example: The OIG sentenced a physical therapist to six months of incarceration for work that wasn't performed -- in fact, the PT "submitted [...]
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