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Anti-Fraud Reviews

  1. Default Anti-Fraud Reviews
    Medical Coding Books
    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

  2. #2
    Louisville, KY
    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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