#DYK: Health care fraud impacts the public, both as patients and taxpayers! HHS-OIG and our federal partners will continue to vigorously investigate and pursue those who abuse and take advantage of health care programs. Report fraud at TIPS.HHS.GOV
HHS Office of Inspector General’s Post
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Healthcare Revenue Cycle, CDI, Coding&Compliance- Expert SOLVING ISSUES that BLOCK effective WORKFLOW & ACCURATE PAYMENT
Very important to understand for all providers not just new physicians.
#ResourceAvailable: Health care fraud and abuse laws are designed to protect patients and prevent fraud, waste, and abuse in federal health care programs. HHS-OIG reminds new physicians and health care organizations about five important fraud and abuse laws: https://bit.ly/3w22ROA.
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False Claims Act is the number one problem physicians, hospitals, medical device manufacturers, and pharmaceutical companies face. It is easy to fall into gray areas when a federal or state agency introduces or changes the billing protocols and providers receive incorrect training. A pharmacy sales team member overstates a medical device or drug FDA approval. The misconception leads medical providers to file claims and reimbursement based on inaccurate information. In my last case, multiple providers filed and received over five million dollars of corrected claims. A year later, they were notified and faced state false claims. Thank God a provider's attorney filed a motion requesting an Independent Auditor to review the claims. Proving actual intent is hard and but researching the cause, explaining the correct filing procedures, and calculating their accurate compensation. At the same time, some were not happy with their recoupment amount. Then you kindly drop, "Once informed of an overpayment relating to Medicaid or Medicare, a provider must return the funds within 60 days. " So don't be afraid to ask for an Independent Auditor. Lady Leslie Reimbursement Auditor Lady.Leslie @lmnewson.com
#ResourceAvailable: Health care fraud and abuse laws are designed to protect patients and prevent fraud, waste, and abuse in federal health care programs. HHS-OIG reminds new physicians and health care organizations about five important fraud and abuse laws: https://direc.to/fgsf
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Check out this HHS OIG Fraud Risk Indicator update. It includes a solid explanation on actions, a risk spectrum chart, published criteria pdf, as well as a number of other fraud related links. This is great information especially for medical investigations. #fraudprevention #analytics #crimeanalysis #investigations #claims
HHS-OIG has updated the 2023 Fraud Risk Indicator for Q3. Based on information from False Claims Act settlements, HHS-OIG assesses the future trustworthiness of the settling parties to decide whether to exclude them from federal health care programs. Read more: https://direc.to/fgx8
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#ResourceAvailable: Health care fraud and abuse laws are designed to protect patients and prevent fraud, waste, and abuse in federal health care programs. HHS-OIG reminds new physicians and health care organizations about five important fraud and abuse laws: https://direc.to/fgsf
#ResourceAvailable: Health care fraud and abuse laws are designed to protect patients and prevent fraud, waste, and abuse in federal health care programs. HHS-OIG reminds new physicians and health care organizations about five important fraud and abuse laws: https://direc.to/fgsf
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#ResourceAvailable: Health care fraud and abuse laws are designed to protect patients and prevent fraud, waste, and abuse in federal health care programs. HHS-OIG reminds new physicians and health care organizations about five important fraud and abuse laws: https://bit.ly/3w22ROA.
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Risk Adjustment | Revenue Cycle | Social Determinants of Health | I help organizations optimize revenue cycle operations to maximize risk adjustment financial success.
Need help understanding how these apply to risk adjustment, or how your organization's compliance plan should incorporate preventive strategies specific to risk adjustment? Reach out to us at Centauri Health Solutions, Inc. My virtual door is always open!
#ResourceAvailable: Health care fraud and abuse laws are designed to protect patients in federal health care programs. HHS-OIG reminds new physicians and health care organizations about five important fraud and abuse laws: https://direc.to/fgsf
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