decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Program Safeguard Contractors - Overview / Auditing by PSCs
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Article Overview
This article explains the general role of Program Safeguard Contractors (PSCs) in Medicare program integrity work. It outlines the kinds of information that may trigger an investigation, the broad methods used to review claims and documentation, and the types of administrative and investigative follow-up that may occur when concerns are identified. It is intended for readers who handle Medicare billing, compliance, audit response, or fraud and abuse oversight.
Why This Topic Matters
Understanding PSC activity helps providers and billing professionals recognize the kinds of reviews Medicare integrity contractors may conduct and the general consequences that can follow an investigation.
What You Will Learn
- How PSC investigations may begin
- What broad review methods PSCs may use
- What types of follow-up actions may occur after a PSC review
- How PSC activity fits into Medicare program integrity oversight
Who Should Read This
- Healthcare providers
- Medical coders
- Billing staff
- Compliance officers
- Practice managers
- Healthcare auditors
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