Compliance: Overbill And Risk Paybacks Down The Road

Article Overview

This article discusses a government audit of billing and reimbursement for an injectable drug, highlighting how coding and payment discrepancies can trigger compliance scrutiny and future paybacks. It is relevant to coders, compliance staff, revenue cycle teams, and practices that bill Medicare and other payers for drug administration or specialty medication claims. The article focuses on audit findings, payer review activity, and the importance of validating claims before responding to payer inquiries.