E/M Coding Alert - 2015 Issue 17
Part B Mythbuste: 10 Compliance Realities That You Can't Afford to Ignore
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Article Overview
This article reviews a set of common Medicare-related billing and compliance myths and explains why they matter to practices, coders, and billing staff. It is aimed at readers who handle documentation, claims, payer communications, and compliance oversight, and it discusses broad themes such as audit risk, whistleblowers, payer review, fraud exposure, and keeping current with government guidance.
Why This Topic Matters
Understanding these compliance misconceptions can help practices recognize where billing assumptions may create audit, repayment, or enforcement risk. The article is relevant for anyone involved in Medicare billing, coding, documentation, or compliance oversight.
Article Sections
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Introduction
An overview of the article’s focus on common billing and compliance misconceptions and the risks they can create for practices.
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Ten common misconceptions
A numbered discussion of broad Medicare billing and compliance myths involving practice size, compliance programs, payer review, staff concerns, documentation, payer participation, government enforcement, and related oversight issues.
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Resource
A reference to additional material for readers seeking more information on billing misconceptions and compliance topics.
What You Will Learn
- How common Medicare billing myths can affect compliance risk
- Why audit and fraud concerns matter even for smaller practices
- What general areas of payer and government oversight are discussed
- Why compliance programs and documentation review are emphasized
- How staff concerns and whistleblowers fit into compliance management
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Compliance officers
- Physicians
- Healthcare administrators
Codes Discussed
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