tci Medicare Compliance & Reimbursement - 2006 Issue 15

CONSULTATIONS: OIG Initiates A New Crackdown On Consult Billing

Three out of four consults billed incorrectly, OIG says.Consults look like a juicy target to fraud-busters in the wake of a new HHS Office of Inspector General report that found 75 percent of consults didn't meet Medicare requirements. Only one-third of the dollars providers billed in 2001--$1.1 billion out of $3.3 billion--were incorrect, but that's still a high price tag.The OIG report reveals that: · Providers billed nearly half of all consults (47 percent) as the wrong type of consult or at an incorrect level, accounting for $613 million in consult billings. In particular, providers...

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