decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Physician Practice Model Compliance Plan / Specific Risk Areas / Additional Risk Areas / Billing Practices by Non-Participating Physicians
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Article Overview
This article explains a set of Medicare billing compliance concerns for non-participating physicians. It focuses on how billing rules affect charges to Medicare beneficiaries, when refunds may be required, and the potential consequences of noncompliance. The material is aimed at physicians, practice managers, compliance staff, and billing professionals who need a general understanding of Medicare beneficiary billing risk areas.
Why This Topic Matters
Understanding these compliance topics helps practices reduce risk when billing Medicare beneficiaries and maintain awareness of legal and program-related obligations tied to non-participating physician services.
What You Will Learn
- The general compliance issues affecting billing by non-participating physicians
- When beneficiary billing may create Medicare-related risk
- Why refunds may be required in certain billing situations
- What kinds of penalties may be associated with noncompliance
Who Should Read This
- Physicians
- Practice managers
- Compliance officers
- Medical billers and coders
- Revenue cycle staff
Codes Discussed
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