For a provider of healthcare services, payer audits are always a possibility. Both government and private payers consistently monitor providers to prevent fraud, overpayment, and improper billing or coding procedures. Audits can be nerve-racking and intimidating, even if a provider is billing correctly. Improper billing can lead to civil and criminal sanctions. To alleviate some…
Both government and private payers continue to aggressively monitor providers to prevent and recover overpayments. This is evidenced by the fact that the number of audits conducted in recent years has increased dramatically. A negative audit finding can result in the need to repay five- or seven-figure amounts. Types of Audits Private Payer Audits Private…
Tips for creating, maintaining and enforcing an effective plan
Know what’s included in the federal False Claims Act, Anti-Kickback Statute and other regulations and guidelines to prevent Medicare abuse