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  • Posts tagged "Upcoding"

Posts tagged "Upcoding"

Top Coding and Billing Errors to Avoid

September 5, 2023 / admin / Articles, Authorization Failures, Bad Sequencing, Benefits Errors, Billing, Billing Duplicates, Duplicate Coding, EOB Errors, Expired Policy Numbers, Grouping Errors, Insufficient Modifiers, Invalid Linkages, Invalid Place of Service, Missing Codes, Missing Modifiers, Poor Handwriting, Timed Coding Errors, Unbundling
Medical Billing White Guy

Accuracy in both medical coding and billing processes is imperative for maximizing appropriate reimbursement, maintaining regulatory compliance, and optimizing revenue cycle performance. Even minor errors can have major consequences in delayed or reduced payments, denied claims, and compliance risks. We cover the most common coding and billing mistakes along with best practices to identify where […]

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Authorization Failures, Bad Sequencing, Benefits Errors, Billing, Billing Duplicates, Duplicate Coding, Duplication, EOB Errors, Expired Policy Numbers, Grouping Errors, Inaccurate Patient Info, Inaccurate Patient Information, Inadequate Specificity, Incorrect Code Assignments, Incorrect Units, Insufficient Modifiers, Invalid Linkages, Invalid Place of Service, Medical Billing, Missing Codes, Missing Modifiers, Poor Handwriting, Timed Coding Errors, Timeliness Issues, Unbundling, Upcoding

Medicare and Medicaid Fraud: A Growing Problem in the Healthcare Industry

February 2, 2023 / admin / Articles, Billing, Billing Services Not Rendered, Claim Billing, False Certification, Fraud, Healthcare, Healthcare Billing, Kickbacks, Medicaid, Medicaid Fraud, Medical Billing, Medical Claims, Medicare, Medicare Fraud, Phantom Billing, Prescription drug fraud, Supply Fraud, Unlawful Self-Referral, Upcoding, Whistleblower Protection Act
Medicare Fraud

Medicare and Medicaid Fraud is a Massive Healthcare Industry Problem Medicare and Medicaid Fraud Vulnerability The Medicare and Medicaid programs provide crucial support to millions of Americans, offering access to healthcare services for those who may not otherwise be able to afford it. Unfortunately, these programs are also vulnerable to fraud, with criminals exploiting the […]

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Billing for Services Not Rendered, Billing Fraud, False certification, Fraud, Kickbacks, Medicaid, Medicaid Fraud, Medical Billing Fraud, Medicare, Medicare Fraud, Phantom billing, Prescription Drug Fraud, Supply fraud, Unlawful self-referral, Upcoding, Whistleblower, Whistleblower Protection Act

Common Cases of Medicare, Medicaid Fraud

December 8, 2021 / admin / Articles, False Claims Act, Fraud, Medicaid, Medicaid Fraud, Medicaid Fraud Examples, Medicare, Medicare Fraud, Medicare Fraud Examples, Phantom Billing, Unbundling, Upcoding
Medicare Fraud

Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It *These are examples of fraud as it relates to Medicare and Medicaid. Medical fraud is the intentional deception or misrepresentation of healthcare transactions by the provider for the sake of receiving unauthorized benefits or financial gain. Healthcare fraud is committed when a dishonest […]

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Billing Fraud, False Claims Act, Fraud, Medicaid, Medicaid Billing, Medicaid Fraud, Medicaid Fraud Examples, Medical Billing Fraud, Medicare, Medicare Billing, Medicare Fraud, Medicare Fraud Examples, Upcoding

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
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  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

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  • White Male Medical Doctor Needing Credentialing

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  • How to Fight Back Against Low Out-of-Network Payments

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