Untrained Medical Billing Staff will Drive Fraudulent Risk
In order for healthcare facilities, hospitals and clinics to contain fraud or unintentional fraud, hiring to certified medical billing and coding services is of utmost importance. Today millions of healthcare claims are processed every year by private insurers and governmental agencies like Medicare and Medicaid. Healthcare providers that submit incorrect or erroneous claims may face allegations of fraud. This might result in fines and loss of reputation and good industry standing. When most people think of fraud, they see it as a deliberate act of deceit. But that's not always the case. The vast majority of doctors are trying to make an honest living. Get Perfect with Your Codes There are thousands of medical codes and code combinations available today. They represent a type of visit, diagnosis, how a procedure was performed, whether more than one procedure occurred at the same time, the extent of a patient's examination, etc. Some examples of improper submissions include ‘upcoding’. It simply means using inappropriate medical billing codes to indicate that a more complex or lengthy procedure was performed. Then there is ‘unbundling’ of codes, which is using different codes for each step of a medical procedure even when one code assigned to cover all steps in the procedure will do. Vital Points to Avoid Fraud at your Medical Facility Know your Coding and Billing Staff.
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