decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Mental Health Services / Fraud Alerts / 1993 Fraud Alert - Psychological Testing, with Written Report Per Hour
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Article Overview
This article summarizes an OIG fraud alert involving psychological testing services billed to Medicare and explains why the issue matters for compliance and claim review. It is aimed at mental health providers, billing staff, auditors, and carrier or payer review personnel who need to understand the general nature of the billing concern and the types of red flags described in the alert.
Why This Topic Matters
It highlights a Medicare fraud risk area involving time-based mental health testing claims and shows why accurate documentation and review of reported service time are important for payment integrity.
What You Will Learn
- The general compliance concerns associated with time-based psychological testing claims
- Why unusually uniform or repeated time reporting can draw scrutiny
- How fraud alerts are used to identify billing patterns of concern in mental health services
- The role of payer review staff in monitoring claims for potential misuse of time-based services
Who Should Read This
- Clinical psychologists
- Mental health providers
- Medical coders
- Billing staff
- Compliance officers
- Payer review staff
- Auditors
Codes Discussed
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