decisionhealth Newsletters, Answer Books - 2008 Issue 5 (May)
Answer_Book / Limiting_Charge / Penalties_for_balance_billing_violations
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Article Overview
This premium article covers Medicare limiting-charge compliance and the enforcement pathway that can follow repeated violations. It is aimed at billing, compliance, and reimbursement professionals who need a high-level understanding of the subject, the role of the Office of Inspector General, and the types of penalties that may be imposed when limiting-charge rules are not followed.
Why This Topic Matters
Understanding these penalties helps practices recognize the seriousness of limiting-charge compliance issues and the possible consequences of repeated violations under Medicare oversight.
What You Will Learn
- How limiting-charge enforcement may escalate after repeated warnings
- What role the Office of Inspector General can play in enforcement
- The general categories of penalties associated with balance billing violations
- How compliance concerns relate to Medicare participation
Who Should Read This
- Medical coders
- Billing specialists
- Practice managers
- Compliance officers
- Reimbursement staff
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