tci Part B Insider - 2009 Issue 39

COMPLIANCE: Spot Potential Fraud on Your Provider's Claims? Check Documentation, Then Contact Provider

Examine claims for odd activity, experts say. With compliance in the spotlight, many coders are on high alert. Know what to do if you come across a questionable claim. President Obama has made it a priority to curtail Medicare fraud, and major media outlets including 60 Minutes have recently profiled this growing problem. The increased attention on staying compliant has caused medical coders across the country to check and double-check their physicians' documentation to detect issues. How can you recognize fraud? The OIG has issued scores of documents that profile the types of fraud that they are investigating. For...

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