COVID-19 Upcoding: What You Need to Know

HHS’ Office of Inspector General (OIG) will be monitoring COVID-19 billing.

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The higher reimbursement rates for COVID-19 have gained a lot of attention. To make sure upcoding is not occurring, OIG will be monitoring billing and claims data.

What does this mean for your practice?

COVID-19 has impacted most healthcare organizations and practices need to understand that scrutiny will accompany reimbursements.

Practices need to make sure they are coding and billing accurately, especially in regards to COVID-19. Stay up to date on the latest guidance regarding COVID-19 codes and make sure your billing staff is up to date too.

How can you ensure billing and coding accuracy?

Make sure that you are following your compliance plan! If you think your staff needs a refresher training, you can have a Zoom training.

Also, make sure to audit!

Perform internal audits to double check that your practice is correctly coding and billing. If you aren’t sure, reach out to your healthcare attorney. An outside auditor should be able to provide guidance.

Make sure that you are maintaining your process to receive internal fraud reports and complaints. Remind your staff that this exists, so they feel comfortable alerting the practice anonymously.

If you find any issues, investigate. Make sure you understand why the problem occurred so that it can be addressed with continuous education.

As guidance surrounding COVID-19 response and recovery continues to emerge, if you have questions, contact your healthcare attorney.

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.

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