If you are billing Medicare, the answer is “yes.”
The Center for Medicare and Medicaid Services (CMS) is tracking all healthcare providers that are billing Medicare. In January 2014, CMS announced that they are encouraging more fines, penalties and exclusions for healthcare providers that are over billing Medicare. Because 300 healthcare providers are receiving more than $3 million dollars from Medicare, CMS is targeting providers. CMS Directive
Special attention will be paid to internal medicine, radiation oncology and ophthalmology. CMS is demonstrating they are less willing to work with a provider to correct mistakes, but rather will exclude the provider from Medicare altogether.
Additionally, CMS announced that they will publicly disclose how much healthcare providers are paid by Medicare.
As we know, Medicare will view a lack of documentation as billing for unnecessary services.
So what should you do?
1) Assess Your Compliance Plan?
Is it an active daily plan or is it a book on a shelf gathering dust?
2) When did you perform your last audit?
Remember: a compliance plan is like a quality assurance program. You are checking your services to make sure you are doing things right and improving where you can.
3) Have you compared your billings with your competitors?
Medicare is looking at your billings as they compare to other healthcare providers with your specialty. If your billings are significantly higher, you will be a target for the feds.
Do you need help with your compliance plan? We can help. For assistance CLICK HERE.
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