New vs. Established Patient Billing: Are You Doing It Properly?

It’s no secret that the Department of Health and Human Services Office of the Inspector General (HHS OIG) has been scrutinizing how Medicare pays providers for new and established patients. Such scrutiny has resulted in providers having to pay back millions for incorrectly billing for a new patient visit when the visit should have been […]

Billing Medicare for Free Samples Can Land Healthcare Providers in Hot Water

It’s not unusual for physicians to receive free samples to give to their patients. But billing the federal government for them is a definite no-no as one St. Louis, Missouri neurologist recently learned. According to a recent news release from the U.S. Department of Justice, Dr. Sherry X. Ma and her clinic, AIMA Neurology, LLC, […]

CMS’ fraud crackdown relies on high-tech analytics

The government’s crackdown on Medicare fraud is paying off and healthcare providers that bill the government program would be well advised to know that the Centers for Medicare & Medicaid Services is using a high-tech analytics system to identify inappropriate payments. Aptly named the “Fraud Prevention System,” the program has identified or prevented $820 million […]