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Wiki Anti-Fraud Reviews

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Veteran90

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Curious if there are any other coders out there who are using their knowledge of coding guidelines to review for inappropriate / fraudulent coding practices?

I work in a position that requires me to apply my knowledge of coding / medical treatment to the fraud assessment of $billions in submitted medical bills and am looking to network with other coders out there who may be working in a similar situation.

Am I alone in the world?

:-)

Looking forward to some good dialogue on this topic.

- - Jeff, RN, CPC
 
Although the breadth of my duties do not entain billions of dollars, we (as an organization) are charged with reviewing for inappropriateness, which includes fraud, abuse and general coding errors.

I have worked in a previous post where payer program integrity was integral to my job duties.
 
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