According to Ms. Barsalou, fraud can be tackled on many different levels of the healthcare industry. Federal and sate governments can tighten fraud laws and institute tougher penalties. Insurance companies can look to improve oversight in their fraud or special investigations departments.
Coders should remain vigilant by coding only services that are documented, she says. If a coder is asked to add a code or service to a bill, he or she should ask the provider to add it to the patient’s permanent record if it is not currently there. Coders can also report suspected fraud anonymously; most insurers have an anonymous hotline.
Read the AAPC report on healthcare fraud.
Read more on coding:
–ICD-10 Expected to Create Thousands of Coding Jobs
–AAPC Launches ICD-10 Resource Site
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