decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
OIG Investigation Procedures / Extent of Investigation for Services Not Provided as Claimed / Extent of Investigation for Services not Provided as Claimed
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Article Overview
This premium article explains OIG investigation procedures for determining the extent of investigation in cases involving services not provided as claimed. It is aimed at compliance, audit, and coding professionals who need to understand the general factors considered when evaluating civil money penalty cases and the broader investigative process.
Why This Topic Matters
Understanding how OIG assesses the scope of investigation helps organizations prepare for compliance reviews, documentation requests, and potential civil monetary penalty actions involving services not rendered as billed.
What You Will Learn
- The general purpose of the OIG investigation procedure described in the article
- The broad factors that can affect how much investigation is performed
- How the article frames civil money penalty cases involving services not rendered as claimed
- The types of administrative considerations that may influence case development
Who Should Read This
- Compliance professionals
- Medical auditors
- Billing managers
- Health care attorneys
- Revenue cycle staff
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