Corporate Compliance

Tip: Risk assessments for False Claims Act purposes

Compliance Monitor, May 28, 2008

To help guarantee accurate claims are submitted, healthcare providers must understand common, long-standing risks associates with claims preparation and submission. Some of these risks, such as duplicate billing and upcoding, are considered straightforward and well understood by the industry.
Other evolving risks are under-recognized. Those risks include:
  • Outpatient procedure coding
  • Admissions and discharges
  • Supplemental payment considerations
  • Use of information technology
This tip was adapted from The Healthcare Compliance Professional’s Guide to the False Claims Act. For more information about the book or to order your copy, click here.


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