Part B Insider (Multispecialty) Coding Alert
Billing Company Pays For Fraudulent Claims
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Think your billing company is immune to fraud charges? Think again.
New York-based billing company Accordis, Inc. agreed to repay $1.36 million in damages and penalties to settle a civil qui tam case claiming Accordis submitted fraudulent claims to Medicare and MediCal, the California Medicaid program. Accordis billed for six Los Angeles county hospitals and more than 80 community clinics, according to a release from the U.S. Attorney of the Southern District of New York.
The government alleged that Accordis used "default" diagnosis codes that were false and bore no relationship to a patient's actual diagnosis or procedures actually performed. Among other false claims, the company used these codes to bill MediCal for abortions, which federal health care programs can't reimburse under federal law. Accordis didn't admit any liability or wrongdoing as part of the settlement.
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