Is your Medicare billing information being released?

The answer is “yes.”

The government is committed to shining a light on what used to be private billing information.

In April 2014, the government released the Medicare billing information for all doctors. The information surprised many patients and doctors.  For the first time, CMS released utilization and payment data to the public so patients could see how much doctors got paid and how often they were ordering tests and procedures.

Many doctors have complained that the data is being misinterpreted by the public since it is released in a raw data format.  CMS does not intend to stop looking at the data and releasing the information.

The initial data showed that only a tiny fraction of the 880,000 doctors and healthcare providers are receiving the majority of the $77 billion Medicare payments.  4,000 doctors received over $1 million dollars from Medicare in 2012.  One single Florida ophthalmologist received over $21 million in one year.

What does this mean to doctors going forward?

  1. Your billing information is now being reviewed by more people than ever.
  2. Make sure you are billing all insurance companies correctly.
  3. Be sure to review the reports you receive comparing you to your peers.  Know if you are an outlier.
  4. Keep current on your compliance audits to make sure you are billing correctly.

If you or your entity needs assistance with compliance and billing issues, please do not hesitate to contact our office – we can help.  For assistance CLICK HERE.

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