Avoid billing compliance pitfalls, learn Medicare guidelines
No provider is exempt from following the compliance guidelines of Medicare and the other third-party payers they bill. In most instances, coding compliance guidelines are not strictly adhered to because providers and office personnel are not well educated about the billing rules. However, providers are legally responsible for knowing the compliance guidelines of each payer.
Missteps in adhering to compliance guidelines occur in many ways. For example, Dr. Smith billed a code 99232, daily medical care, level 2, for his elderly patient Mrs. Brown. After his billing person billed the charge to Medicare, the office received a denial stating that the patient was not an inpatient.
Most Viewed
Most Emailed
- 10 Major Changes to Health Reform in House's Reconciliation Bill
- 11 Health Leaders React to House Passing Health Reform
- Where Have All the CEOs Gone?
- Cardiology Group Fights Medicare Pay Cuts by Offering Concierge Services
- House Approves Health Reform, But More Work Remains
- Healthcare industry's winners and losers
- Detroit Medical Center Sale Raises Concerns About Charity Care
- Primary Care is Unappealing to Many Medical Students
- New Joint Commission's Medical Staff Bylaws Standard Strikes Balance
- Match Day a Reminder of Primary Care's Struggles
