tci Part B Insider - 2004 Issue 16

Physician Notes: It's Good To Be Unusual -- But Not In Your Billing Practices

Abnormal patterns trigger scrutiny by OIG, other watchdogs If your claim submissions stick out from those of your peers, make sure you have documentation to back up your services. Otherwise, you could end up on the fast track to an audit by the HHS Office of the Inspector General.   Unusual billing patterns recently sparked scrutiny of New York-based Nassau County Medical Center's psychiatry and psychology departments. According to U.S. Attorney Roslynn Mauskopf, from 1995 to 1999 attending physicians at NCMC made medically unnecessary rounds on weekends and holidays, and also allegedly billed Medicare for the medication management...

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