tci Medicare Compliance & Reimbursement - 2008 Issue 35

Compliance:OIG Gives OK To Outsourcing Pre-Authorizations

But beware any compensation that is based on commissions There's finally some good news for those working with managed care clients.If you have significant managed care business and abhor the tedious job of performing insurance preauthorizations, you may be able to unload the task, according to a new OIG advisory opinion.According to Opinion No. 08-12, a company asked the HHS Office of Inspector General whether its proposed arrangement would violate the anti-kickback statutes.The proposal: Under the arrangement, preauthorization contractor Newco would manage a contract with radiology and imaging centers across the country to provide insurance preauthorizations...

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