E/M Coding Alert - 2012 Issue 27
In other news…
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Article Overview
This short news article covers a new collaboration between the Department of Health and Human Services, multiple insurers, industry groups, and law enforcement to improve detection of potentially fraudulent health care billing. It is relevant to billing professionals, compliance teams, and providers who monitor payer oversight and data-sharing initiatives. The article gives a high-level overview of the partnership and the concerns some providers have about billing-data sharing.
Why This Topic Matters
It highlights increased payer and government scrutiny of claims and signals a broader effort to identify suspicious billing patterns across public and private payers.
What You Will Learn
- What the new anti-fraud collaboration is broadly intended to address.
- Which types of organizations are involved in the partnership.
- Why providers may be concerned about expanded sharing of billing data.
- How the initiative relates to claims oversight and payment integrity.
Who Should Read This
- Medical billers
- Coding professionals
- Compliance officers
- Healthcare providers
- Revenue cycle staff
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