decisionhealth Newsletters, Part B News - 2009 Issue 12 (December)
‘Heightened scrutiny' of claims yields Medicare FFS error rate of 7.8%
Subscribe or sign in to view the full article.
Article Overview
This article summarizes a CMS update on Medicare fee-for-service payment error rates and the broader audit environment surrounding claim review. It discusses CERT findings, the role of HHS OIG recommendations, and why documentation and billing scrutiny matter for providers and billing staff. The piece is relevant for anyone tracking Medicare improper payments, audit risk, and evolving claims review practices across Medicare and Medicaid programs.
Why This Topic Matters
It helps readers understand current federal oversight trends that can affect claim payment accuracy, documentation expectations, and audit preparedness. The article is especially useful for compliance, billing, and coding professionals monitoring improper payment measurements and payer scrutiny.
What You Will Learn
- How CMS reports and frames Medicare fee-for-service error rate results
- What kinds of claims documentation issues auditors are focusing on
- How improper payment scrutiny extends across Medicare and Medicaid programs
- Why providers should review billing and documentation practices in light of audit activity
Who Should Read This
- Medical coders
- Medical billers
- Compliance officers
- Revenue cycle staff
- Practice managers
- Healthcare auditors
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com