Medical Billing Compliance Issues

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What Should Health Care Organizations Do to Reduce …

https://journalofethics.ama-assn.org/article/what-should-health-care-organizations-do-reduce-billing-fraud-and-abuse/2020-03

CMS categorizes fraud and program integrity issues into 4 categories: (1) mistakes resulting in administrative errors, such as incorrect …

Complaints about medical billing | CMS

https://www.cms.gov/nosurprises/consumers/complaints-about-medical-billing

Complaints about medical billing. Starting in 2022, insurance companies and plans, providers, and health care facilities must follow new rules that protect …

Provider Compliance | CMS

https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/providercompliance

Provider Compliance | CMS Publications & Multimedia Provider Compliance Learn how to avoid common coverage, coding, and billing errors with these …

8 medical coding mistakes that could cost you

https://www.ama-assn.org/practice-management/cpt/8-medical-coding-mistakes-could-cost-you

When it comes to medical coding errors, they fall into the broad categories of “fraud” and “abuse.” The former involves intentional misrepresentation. The latter means “the falsification was an innocent …

Top Ten US Health Care Compliance Issues for 2020

https://www.acc.com/resource-library/top-ten-us-health-care-compliance-issues-2020

Areas of due diligence to consider with respect to health care-related transactions include: gaps in understanding of compliance plans or lack of …

What Is Healthcare Compliance? All You Need to Know …

https://www.aapc.com/healthcare-compliance/healthcare-compliance.aspx

Healthcare compliance is the formal name given to proactive tasks to prevent fraud, waste, or abuse within a healthcare entity. A compliance program is the active, …

Common Billing Compliance Pitfalls - AAPC Knowledge …

https://www.aapc.com/blog/37418-37418/

Compliance officers face several major issues in today’s healthcare arena. Besides HIPAA, Stark Law, and Anti-Kickback concerns, certain billing compliance issues continue to appear in federal …

Medicare Compliance Basics: “Incident to” Billing

https://www.foley.com/en/insights/publications/2023/02/medicare-compliance-basics-incident-billing

Failure to comply with the “incident to” rules can lead to issues ranging from claims denials, overpayments, being placed on pre- and/or post-payment review or even …

4 Medical Billing Issues Affecting Healthcare Revenue …

https://revcycleintelligence.com/news/4-medical-billing-issues-affecting-healthcare-revenue-cycle

Neglecting to inform patients about financial responsibility spells collection issues The main goal of medical billing is to collect the full amount for services …

Dealing with Billing and Coding Compliance Issues | Medical

https://www.outsourcestrategies.com/blog/dealing-with-billing-and-coding-compliance-issues/

Failing to do so would result in compliance issues. Coders should submit claims without errors or missing information, as ASCs would have to incur considerable …

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