August 12, 2015 11:00am MT
Learn what constitutes a false claim, who is liable when a false claim is submitted, the difference between "fraud" and "abuse" and how to prevent false claim submission.
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False claims are a liability to your practice. Physicians, office managers, coders, and billers need to be aware of False Claim Act rules and regulations, and the criminal and civil penalties associated with filing false claims. The extent of your responsibility regarding a false claim may be surprising. Understanding the rules will enable your practice to take corrective action when false claims are suspect and to develop policies and procedures to mitigate the risk of future false claims.
About The Author
Janice G Jacobs, CPA, CCS, ROCC, CPC, CPCO
Janice G. Jacobs is a Principal at Jacobs and Associates, LLC, a healthcare consulting and medical billing firm. Janice has over 30 years of healthcare industry experience including hospital accounting and auditing, inpatient, outpatient and professional fee coding and compliance and revenue cycle management.
Prior to founding Jacobs and Associates, Janice was a Director at IMA Consulting where she developed their Regulatory Compliance and Coding Practice. Janice also was a Director in Huron Consulting Group’s Healthcare Compliance and Investigations Practice where she worked on numerous engagements at the country’s top Academic Medical Centers including Stanford, Duke, Johns Hopkins and the University of Illinois at Chicago. In both organizations she served as the ICD-10 Task Force Leader.
Janice is a Certified Public Accountant licensed in the State of Pennsylvania, a Certified Professional Coder and a Certified Professional Compliance Officer with the American Academy of Professional Coders (AAPC), a Certified Coding Specialist with the American Health Information Management Association (AHIMA) and a Radiation Oncology Certified Coder with the American Medical Auditing Company (AMAC).
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