Health Information Management

Pay Per View: Know critical care billing, documentation requirements

APCs Insider, March 14, 2008

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

Physicians who take chances by skirting ethics to increase their revenue risk massive financial penalties and the possibility of losing their freedom.

One Philadelphia hospital group was forced to pay $30 million in fines for fraudulent billing.

New Jersey's Blue Cross and Blue Shield recovered more than $10 million from physicians who billed for procedures with inappropriate codes or without ever having performed the stated procedure.

Medicare recovers thousands of dollars daily from physicians who bill a higher professional level than that which the patient's actual acuity level validates. The physicians do this with the erroneous expectation that no one will ever investigate them. Insurers' investigations often reveal healthcare providers who bill for services they never rendered; products they never delivered; misrepresented, unbundled, medically unnecessary, or duplicate services; increased units of services; false cost reports; kickbacks--and the list goes on.

Click here to learn more about critical care billing and documentation requirements. Medical Records Briefing subscribers have free access to this article in the February issue via their online subscriptions.



Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

Comments

0 comments on “Pay Per View: Know critical care billing, documentation requirements

 

    Briefings on APCs
  • Briefings on APCs

    Worried about the complexities of the new rules under OPPS and APCs? Briefings on APCs helps you understand the new rules...

  • HIM Briefings

    Guiding Health Information Management professionals through the continuously changing field of medical records and toward a...

  • Briefings on Coding Compliance Strategies

    Submitting improper Medicare documentation can lead to denial of fees, payback, fines, and increased diligence from payers...

  • Briefings on HIPAA

    How can you minimize the impact of HIPAA? Subscribe to Briefings on HIPAA, your health information management resource for...

  • APCs Insider

    This HTML-based e-mail newsletter provides weekly tips and advice on the new ambulatory payment classifications regulations...

Most Popular