BC Advantage - 2012 Issue 11

Clustering Levels of Evaluation and Management Services: Avoid the Compliance Trap

Clustering levels of Evaluation and Management Services is not a new concept but is something that continues to be a hot topic of conversation spanning everyone from The CMS to the OIG and everyone in between. In 2000, the Office of Inspector General released its Guidance for Individual and Small Group Physician Practices and identified this new risk. Since then, carriers have maintained a maniacal focus on identifying these outliers and recouping monies providers were not entitled to. Along the way, many providers found themselves in more trouble than they bargained for as to their surprise they were slapped...

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