decisionhealth Newsletters, Part B News - 2013 Issue 2 (February)
Beware of charging fees that will land your practice in hot water with OIG
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Article Overview
This article reviews when administrative or convenience fees can create compliance problems for medical practices, especially in the Medicare context. It discusses the general categories of fees and services that may raise concerns, along with broader considerations involving private payers, missed-appointment fees, medical record copying charges, and prescription refill handling. The piece is intended for practice administrators, physicians, and coding/compliance professionals who need to recognize fee-related risk areas without relying on premium content.
Why This Topic Matters
Patient fee policies can trigger reimbursement disputes, refunds, or government scrutiny when they overlap with services already included in payer payments. Understanding the scope of these compliance risks helps practices reduce exposure and evaluate whether common office fees are properly structured.
What You Will Learn
- How patient-facing administrative fees can create compliance concerns
- Why Medicare assignment rules are central to fee-related risk
- What general fee categories are commonly reviewed for compliance
- How state and payer rules can affect certain practice charges
Who Should Read This
- Physicians
- Practice administrators
- Medical coders
- Compliance staff
- Billing staff
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