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Reporting Problems Found in an Audit
We have been doing self-reviews of our charts and coding procedures. We’ve found several errors, meaning wrong codes billed for both inpatient and outpatient services. We aren’t sure if rebilling with correct codes will raise red flags with our payers. However, we all believe that catching and correcting our errors prior to the payers catching them would be our best bet. Are we opening ourselves up for problems, or are we being responsible and heading off future problems?
Question: We have been doing self-reviews of our charts and coding procedures. We’ve found several errors, meaning wrong codes billed for both inpatient and outpatient services. We aren’t sure if rebilling with correct codes will raise red flags with our payers. However, we all believe that catching and correcting our errors prior to the payers catching them would be our best bet. Are we opening ourselves up for problems, or are we being responsible and heading off future problems?
Answer: If you discover an overpayment, you have an obligation to repay. If the overpayment looks as if it’s systemic or could have gone on for some time, get legal counsel involved. The problem will be evaluated by looking at the number of visits involved and whether there is a problem with your internal processes that you didn’t realize - for example, that your staff was changing the codes before the bill went out.
You’ll also want to have a documented plan in place for making sure it doesn’t happen again.
Asset Protection and Financial Planning
December 6th 2021Asset protection attorney and regular Physicians Practice contributor Ike Devji and Anthony Williams, an investment advisor representative and the founder and president of Mosaic Financial Associates, discuss the impact of COVID-19 on high-earner assets and financial planning, impending tax changes, common asset protection and wealth preservation mistakes high earners make, and more.
How to reduce surprise billing in your practice
November 15th 2021Physicians Practice® spoke with Kristina Hutson, a product line developer at Availity, about surprise billing events in independent healthcare practices and what owners and administrators can do to reduce the likelihood of their occurrence.
