decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
OIG Investigation Procedures / Investigation of Servicess Not Provided as Claimed / Origin of the Case
Subscribe or sign in to view the full article.
Article Overview
This article covers an OIG investigation procedure related to claims that were not provided as billed and the importance of documenting where the case came from. It is relevant to compliance staff, auditors, investigators, and coding or billing professionals who support fraud-and-abuse reviews. The content gives a general overview of common sources of case discovery and the role of that background in case preparation.
Why This Topic Matters
Understanding how a case originated is an important part of investigation documentation and can affect how compliance, audit, and enforcement matters are framed and reviewed.
What You Will Learn
- How investigation case origins are described in OIG case preparation
- Common ways questionable claims may be identified
- Why documenting the source of a case matters in compliance and investigative work
- The general role of patient complaints, informants, and payer or audit reviews
Who Should Read This
- Compliance officers
- Medical auditors
- Coding professionals
- Billing staff
- Fraud and abuse investigators
- Healthcare administrators
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com