BC Advantage - 2021 Issue 12

Why Quality Documentation Matters

If you work with provider claims in a medical office, then you have probably heard the phrase, "If it isn't documented, it wasn't done." But a 2020 Center for Medicare and Medicaid Services (CMS) report found that more than 70 percent of claims submitted for payment were paid improperly, meaning something was incomplete or missing from the documentation submitted with a claim.The Medicare Fee-for-Service Supplemental Improper Payment Data report* found 74.1% of the Part B improper payments were due to missing/inadequate documentation. The missing information included things like inadequate documentation to support medical necessity or missing...

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