tci Part B Insider - 2003 Issue 23

Physician Notes: OIG Puts Bull's Eye on ASC Claims

Watch out for audits, scrutiny from carriersIt's like the shockwave before the stampede - when the HHS Office of Inspector General identifies a new area of payments it considers a problem, you know the carriers will start looking into it before too long. So, brace yourself for audits and claims scrutiny of ambulatory surgical center procedures. The OIG warns in its latest report, "Review of Payments Made By National Heritage Insurance Company For Ambulatory Surgical Procedures For Calendar Year 2001" (A-01-02-00524), that physicians improperly used a nonfacility place-of- service code for ASC procedures. For 63 out of...

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