1) Discuss some common causes for coding errors and the preventative measures you can use to avoid them.
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Write My Essay For Me2) What are some other measures you can add to the list that might not be in the course materials?
3) What is the Fraud and Abuse Control Program? What is the HHS OIG and what is it’s major concern? (Be sure to watch the video below.)
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Watch Video
A Roadmap for New Physicians: Avoiding Medicare and Medicaid Fraud and Abuse http://www.youtube.com/watch?v=0yRo-YmITus
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The video summarizes the five main Federal fraud and abuse laws (the False Claims Act, the Anti-Kickback Statute, the Stark Law, the Exclusion Statute, and the Civil Monetary Penalties Law) and provide tips on how physicians should comply with these laws in their relationships with payers (e.g., the Medicare and Medicaid programs), vendors (e.g., drug, biologic, and medical device companies), and fellow providers (e.g., hospitals, nursing homes, and physician colleagues). |
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Use in-text citations appropriately and provide full citations for your initial post and at least one of your response posts. One of your citations needs to be outside of your text.
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Quetsy Garcia
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- These are some of the most common causes for coding errors:
- Incorrect coding
- Upcoding
- Unbundling of services
- Billing for medically unnecessary services
- Billing for services not covered under health plan
- Duplicate billing
- What are some other measures you can add to the list that might not be in the course materials?
- Reviewing to assure there is no incorrect information for the patient (name, sex, date of birth, insurance ID information, etc.)
- Assuring insurance provider information is accurate (policy numbers, address, contact information, etc.)
- Inputting the wrong codes or confusing codes such as CPT codes, point of service codes, or ICD-9-CM codes
- Entering too few or too many digits for ICD-9-CM codes
- Inputting mismatched treatment and diagnostic codes
- Forgetting to input codes at all for services performed by a physician or another healthcare official
- Not having access to EOBs on denied claims
- Not verifying a patient’s insurance coverage
- What is the Fraud and Abuse Control Program? What is the HHS OIG and what is it’s main concern?
- HHS is a Fraud and Abuse Control Program
- OIG carries out nationwide audits and investigations. They have the authority to investigate basically any healthcare facility.
- There primarily concern is to make sure business comply with principles of business practice and avoid healthcare providers committing fraud.
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