Aug 28, 2012

Identify Your Own Fraud and Abuse Red Flags

One way to help keep your practice operations squeaky clean and in compliance with fraud and abuse laws is to develop an internal set of warning indicators.

These might include:

  • Significant changes in the number and/or types of claim rejections and/or reductions,
  • Correspondence from carriers and insurers challenging the medical necessity or validity of claims, Illogical patterns or unusual changes in coding patterns or usage, and
  • High volumes of unusual charge or payment adjustment transactions.

Find out what you can do about it.

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