Worried About Up-Coding?

In the wake of the TeamHealth Holdings settlement, it might be time to perform an internal audit and make sure no one at your practice is guilty of up-coding.

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TeamHealth Holdings, a major hospital service provider, is settling allegations of up-coding for $60 million plus interest.

Up-coding is the practice of billing for higher and more expenses of medical service than were actually rendered.

TeamHealth allegedly up-coded Medicare, Medicaid, the Defense Health Agency and the Federal Employees Health Benefits Program in violation of the False Claims Act.

As an additional part of its settlement, TeamHealth entered into a five year Corporate Integrity Agreement with the Department of Health and Human Services Office of the Inspector General. This will help to increase its transparency and accountability in the future.

The federal government continues to express a desire to ensure that health care providers bill government programs appropriately.

The government continues to place a strong emphasis on combating health care fraud.

We help our clients perform internal audits as part of their ongoing compliance plans to ensure that they are billing accurately.

Training is an essential part of billing and coding compliance.

Now is the time to check that your practice’s billing is accurate and without errors. It is essential that regular audits and training is conducted.

The government continues to express that false documentation is not acceptable, but rather is illegal and providers who bill fraudulent claims will be held accountable.

In our next blog post, we will keep you informed of related issues.  To get this important information delivered directly to your mail box, 

Do you need help staying current and compliant with the latest laws, rules and regulations?  We can help. To contact us about your new government rules and regulations, your practice’s risk assessment, or about your other legal needs:  CLICK HERE.

P.S. If you or your patients are interested in consumer healthcare issues, check out myhealthspin.com.

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