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Pediatric Coding Alert

Compliance:

Make Sure Your Billing Service Isn't Putting You at A Compliance Risk

Published on Mon Oct 03, 2011

This billing service overcharged Medicaid by millions for physicians' charges.If your pediatric practice has hired a billing service to handle your claims processing, you can't simply sit back and let them worry about correct coding. In some cases, your billing service could be doing you more harm than good, and you won't know unless you monitor them from time to time.In September, a California-based billing company agreed to pay the U.S. government $4.6 million to settle allegations that it submitted false claims to Medicare and Medicaid on behalf of physicians, hospitals, and other healthcare providers, a Dept. of Justice news release notes. Over a seven-year period, the billing company allegedly inflated claims, billing higher levels of E/M services than the physicians actually documented. In addition, the company added charges for minor services to the E/M claims, and failed to comply with the government's teaching physician rules.The takeaway: It's unclear from [...]
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