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Medicare Fraud one of the Biggest Exposes in Recent times

October 10, 2012 by MedicalBillingStar Leave a Comment

The Biggest Expose in Recent times !

The healthcare industry is in the news once again. But this time, forentirely the wrong reasons. Medicare fraud has always been discussed about in hushed whispers. The lack of concrete evidence and mutual finger pointing ensured that allegations and counter allegations, soon faded into oblivion.

A 430 Million Dollar Scam.

We repeatedly hear of doctors being brought to book for billing errors. But more often than not it turns out to be miscommunication between the patient and doctor or not following revised guidelines. The recent expose that indicts over 90 physicians for submitting fraudulent bills and cheating medicare of four hundred and thirty dollars reveals a much darker story.

Higher Healthcare Costs… 

It is coordinated frauds like this that hike up the average patient’s bill, medico-legal experts allege. But the biggest fallout of this scam could be that physicians who make genuine mistakes with their bill could face more stringent action. Not to speak of the loss of faith and belief, of the public.

Steering Clear of the Muck.

Physicians will have to ensure that every claim sent out is thoroughly scrubbed and “clean”. A scam of this magnitude is certainly going to put everybody else in the scanner. And as skeletons keep tumbling out of the closet, the dust is not going to settle down anytime soon. Medical practices will have to be fully aware of, and pay close attention to the billing process.

The Man in the Mirror…

Like the cult song, nothing much is going to change if the man in the mirror refuses to change. No healthcare reform, billing audit or screaming headline is going to bring about a better and safer healthcare environment, unless physicians take it upon themselves to ensure their medical practice bills the right way ! Or call up their physician billing company to ensure that they’re following all billing regulations.

Medicare frauds recent issues from ango Mark

Filed Under: Medicare Tagged With: Healthcare Claims Processing Services, Healthcare Medical Billing Company, Healthcare Medical Billing Services, Medicare Billing Company, Medicare Billing Fraud, Medicare Billing Services, Physicians billing Company, Physicians billing services

Spend the Extra Hour on your Revenue Cycle Management .

October 2, 2012 by MedicalBillingStar Leave a Comment

What is the latest news Update about Medicare? And How much of it Real ?

There is no other update that can cofound physicians, patients and the common man, more than healthcare updates. Every other day the grapevine is buzzing with news of unfair healthcare providers who upcode and embezzle thousands of dollars and physicians complaining about draconian insurance reimbursement cuts.

11 Billion Dollars of Lost Revenue ! 

The centre for public integrity recently blamed healthcare providers for upcoding and creating questionable medical claims. According to the report over 11 billion dollars of Medicare money was spent on paying up for, what were apparently billing malpractices. With everybody pointing an accusatory finger at everybody else, it is high time physicians take stock of the situation.

An Unfair World… 

It can be increasingly tough, confusing and challenging to be a healthcare provider. On the one hand there are revisions and guidelines that require expensive and frequent system and workflow upgrades. And on the other audits that always hold up the physician for documentation or billing errors. We are not even going to talk about fussy and doubtful patients here.

More Involvement in the Revenue Cycle Management Process…

The business side of medicine is no walk in the park. Doctors make the mistake of being completely unconnected to their revenue cycle management or billing process. The need of the hour is to create a more accountable and sustainable revenue cycle system that keeps the doctor in the loop.

Being unaware of how claims are coded, or being in the dark of which claims are languishing as pending account receivables can lead to embarrassing consequences.

No matter how frustrating it is to keep tabs of the latest physicians billing services revisions or coding updates, it is imperative that physicians spend that extra hour or two on their billing process.

Minor Changes to your Daily Schedule !

One step at a time can help physicians create a healthier medical practice. As most medical practices either outsource their revenue cycle management services needs, or have a separate RCM and billing division, it is essential that, periodic audits are performed.

Monthly or weekly reviews have to be requested for and analyzed. It can be a lot on the plate. But investing that extra hour going through your weekly report can help identify flaws and anomalies before they become the next big statistic !

Filed Under: CFO'S Corner, Revenue cycle management Tagged With: Account Receivables Follow Up, Healthcare Claims Processing Services, Medicare Billing Services, Physicians billing services, Revenue Cycle Management Process, Revenue Cycle Management Services

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