Fraud

jmcpolin

True Blue
Messages
841
Location
Salt Lake City
Best answers
0
Would it be considered fraud if an Urgent care clinic is billing for global xrays and not dictating a separate xray report. There is not even views mentioned in the report. It is my understanding if the physician wants to bill for the reading there has to be a separate dictated report.
 

cheermom68

Expert
Messages
451
Location
Evansville Indiana
Best answers
0
IOM 100-4, chapter 13, section 100.1
"A professional component billing based on a review of the findings of these procedures, without a complete, written report similar to that which would be prepared by a specialist in the
field, does not meet the conditions for separate payment of the service."

LeeAnn
 

dclark7

True Blue
Messages
723
Location
Hartford, CT
Best answers
0
IOM is the Internet Only Manual for CMS. You can access it by going to the CMS website and then going to the heading Regulations and Guidance, under Guidance you'll find Manuals.
 
Top