Miscoding on the Billing Forms Discussion Board
The fundamental basis for auditing Medicare and Medicaid billing is that the services provided are confidential, patient privacy must be protected, and the written word of the provider is the record of service provision upon which a review must be initiated (Harris, 2007). Auditing, however, must extend beyond the written record to establish that the services were actually provided to the patient or client and that the services were rendered according to the conditions described in the provider's written record (Harris, 2007)
As the practice manager, I would remind the physician that every employee has a duty to cooperate and a duty of loyalty to the employer. And I would explain that these duties obligate employees to comply with reasonable directions from their employers during an internal investigation. The employee should be party to a conversation that an internal investigation may or may not commence based on the information provided, however, not providing information and cooperating with my word as a practice manager will not alter the course of the next steps that will be taken.
Since every healthcare organization,...
Originally, this included 120 days of hospital benefits and 120 days of nursing-home benefits. General revenue funds from the program would also be applied towards hospital construction equipment purchase and grants to teaching hospitals. The second part of the law, also known as Part B, concerned physician visits. Initially, Part B was known as Eldercare, the American Medial Association's (AMA) alternative to Medicare. Mills however reformed it to become an
The experiences of seniors within the healthcare delivery system will alter how all Americans view healthcare. The healthcare delivery systems and overall organizational structure in the United States has been slow to adjust but that rest of the world is currently in flux that will migrate into our system. Technological advances in communication have made telehealth and telemedicine vialbel solutions to our outdated healthcare industry orgainzational structre. While these types
Healthcare Fraud Identity theft and fraud of many types and forms are obviously a major inconvenience and hindrance to anyone that falls prey to a person that engages that crime. There are many variants and forms of fraud and identity theft out there. One of the more insidious and nasty examples of those crimes would be that which relates to healthcare. Indeed, to have people's wallet, healthcare and the taxpayer dollar
healthcare issues country. How solve ongoing problem Medicare Fraud Abuse government sufficient effective regulation enforce. If, resolve problem? recommendation ? It Economics Healthcare economically sound. Economics of healthcare The population of the modern day society is faced with incremental pressures, but also incremental challenges, and these new issues impact all aspects of life, including the provision of healthcare services. For instance, the more and more technological developments made within the medical
S. than in any other developed nation, yet the quality of care, even for those who are insured, is mediocre at best (Hawkins, 2007). Doctors and hospitals often treat patients free of charge, if they do not have health insurance. However, that raises costs for other patients and makes healthcare and insurance even more costly. Most Americans recognize that the country's healthcare system is not sustainable and that without significant reform,
Medicare and Medicaid Services (CMS), previously the Health Care Financing Administration (HCFA), that by the time 2011, health care expenditure will arrive at $2.8 trillion, as well as it will bill for 17% of the Gross Domestic Product. As a result, it is no revelation that white-collar offenders observe health care deception as a rewarding effort. Certainly, the General Accounting Office ("GAO") quotes that such deception accounts for up
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