decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Diagnostic Tests / Fraud Alerts / ESRD arrangements for laboratory tests
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Article Overview
This short fraud-alert article discusses how laboratory tests are handled when provided to ESRD facilities under Medicare payment arrangements. It is aimed at billing and compliance professionals who need a general understanding of ESRD laboratory testing arrangements, composite-rate payment context, and the type of improper billing practice the alert is warning about.
Why This Topic Matters
It helps readers recognize a Medicare compliance issue affecting laboratory billing in ESRD care settings and understand why payment arrangements between facilities and labs can draw scrutiny.
What You Will Learn
- How laboratory testing is treated in the ESRD composite-rate environment
- Why certain ESRD laboratory billing arrangements may raise compliance concerns
- The general role of reimbursement agreements between ESRD facilities and testing entities
- How the article frames the issue as a Medicare fraud-alert topic
Who Should Read This
- Medical coders
- Billing staff
- Compliance personnel
- Revenue cycle professionals
- Laboratory billing staff
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