Medicare Compliance & Reimbursement

Medicare paid $34 million for claims with faulty doc numbers. Physicians' NPI numbers will give you a much bigger billing headache if a federal watchdog agency gets its way. In 2007, durable medical equipment suppliers received $34 million in Medicare payments based on inactive or invalid physician UPINs and National Provider Identifier numbers, the HHS Office of Inspector General finds in a new report (OEI-04-08-00470). That's down from $91 million in 1999 -- but not far enough, the OIG contends. Breakdown: $27.8 million worth of claims with incorrect UPINs were inactive, meaning the practice setting they represented was inactive. The Centers forMedicare & Medicaid Services paid $6 million for claims with invalid UPINs, meaning the UPIN had never been assigned. Only $300,000 in claims had invalid NPIs, since the NPI requirement just took effect in May of that year. Of the claims with inactive UPINs, $5 million were due to deceased [...]