tci Medicare Compliance & Reimbursement - 2016 Issue 11

Compliance: Keep Clear, Concise Notes -- Or Face Paybacks

Tip: Ensure your coders get all the documentation upfront. You could face charges of overpayment — and even deliberate fraud — if your documentation doesn’t hold up to scrutiny after your claims are paid. Don’t assume certain details are unnecessary and leave your notes fuzzy, especially when you are admitting patients. In facility settings that provide both inpatient and outpatient services, recording essential details can get particularly tricky. Background: The HHS Office of Inspector General (OIG) published a report recently about a Lafayette, La., hospital that had received $287,257 in overpayments — though the original estimated...

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