BC Advantage - 2023 Issue 7

Overcoding: Putting a Strategic Stop to a Silent Revenue Killer

Overcoding is in the crosshairs as the Centers for Medicare and Medicaid Services (CMS) continues its quest to ferret out fraud and abuse and recoup improper reimbursements-a focus that returns $8 for every $1 spent on audits. There are no signs that they are letting up any time in the future, as the federal government has increased funding for audits and fraud investigations. Overcoding-intentional or accidental-can bring significant fines in addition to repayment of the original claim. And the reputational damage of a fraud finding is hard to overcome. As such, provider organizations need to be vigilant with...

To read the full article, sign in and subscribe to BC Advantage.

Thank you for choosing Find-A-Code, please Sign In to remove ads.