tci Medicare Compliance & Reimbursement - 2019 Issue Q3
Clip And Save: Use These Steps to Cut Down Your Chances of Fraud
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Article Overview
This article discusses Medicare fraud and abuse prevention from a provider compliance perspective. It is aimed at clinicians, practice managers, and billing staff who want a broad overview of risk-reduction practices related to documentation, delegation, patient information, billing oversight, and responding to Medicare contractor requests. The piece also references CMS, a Medicare Administrative Contractor, and a webinar used as the basis for the guidance.
Why This Topic Matters
Fraud and abuse concerns can lead to denials, enforcement action, and payment problems. Understanding the article helps practices identify the kinds of compliance habits and internal controls that are emphasized in Medicare oversight discussions.
What You Will Learn
- How Medicare fraud and abuse risk is framed for provider offices
- Why documentation, billing oversight, and internal controls matter in compliance
- How practice administration and patient information handling relate to fraud prevention
- What kinds of Medicare communications and updates providers are encouraged to monitor
Who Should Read This
- Physicians and other clinicians
- Practice managers
- Medical billing staff
- Compliance personnel
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