Audit Risks Growing for Out-of-Network Providers
Share this page: With audits on the rise, more and more providers tell me they plan to go out-of-network with insurance companies to reduce their risk. If only it were that easy. The rules for billing, coding, and documentation are the same whether you are in-network...
Another Layer of Protection Against Audits, Fines, and Penalties
Share this page: Despite every effort that we make to be compliant when it comes to billing, coding, documentation, and discounts in our practice, we are still human, and mistakes will happen. We know that audits are on the rise and that fines and penalties are enough...
Flip the Script with Shopper Calls to Improve New Patient Volume
Share this page: The biggest pain for many patients comes from the cost of care and not their…well, bodies. As deductibles and co-pays get higher, patients begin to weigh the cost of going to the doctor. In a recent article about the rising number of patients...
Trust, but Verify
Share this page: As far back as 2004, a bulletin for providers published by the Department of Justice and the Federal Trade Commission stated that “…much of the regulatory framework arose haphazardly, with little consideration of how the pieces fit together.” The...
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Why is the Discount Challenge prize amount $15,024? Because that is the average “per-occurrence” fine for Medicare inducements. That’s not $15,024 per patient, that’s not per provider, that’s PER VISIT. Stinks, doesn’t it? To us, the prize amount is worth the investment if we can help our profession better understand proper discounting.