tci Part B Insider - 2012 Issue 14

Physician Note: NJ Doctor Sentenced for Billing 900 Endoscopies on One Patient

Plus: Don't revert to 4010 form if you can avoid it.Wondering whether insurers are actually checking medical necessity for your procedures? One recent case suggests that they are watching carefully.A New Jersey-based otolaryngologist was sentenced last week to two years in prison for defrauding his insurer of over $725,000, an April 9 DOJ press release says. The physician admitted filing false claims for about 900 nasal endoscopies that he purported to have performed on a single patient over several years. The physician continued to file claims for services he said he performed on the patient even...

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