Billing & Reimbursement

Called by some the “King of Nursing Homes” for his many low-income nursing home patients in northeast Illinois, Dr. Venkateswara Kuchipudi was recently convicted for referring patients to Sacred Heart
Continue Reading Nursing Home Fraud Scam Results in Conviction for “King of Nursing Homes”

The Affordable Care Act (ACA) requires Medicare providers to return overpayments within 60 days of the date they are identified in order to avoid liability under the False Claims Act. 
Continue Reading CMS Finally Makes Reasonable Changes to 60-Day Overpayment Rule

Commercial payors are actively looking for ways to reduce payments to out-of-network providers.  One area of focus is discounts and waivers of patient copayments and deductibles by out-of-network providers.  In
Continue Reading Offering Discounts (or Waivers) of Coinsurance/Copayments to Patients as an Out-of-Network Provider

You may have heard that CMS recently expanded its authority to deny enrollment and revoke the Medicare billing privileges of providers and suppliers.  The new changes could affect any physician,
Continue Reading Expanded Authority for CMS to Deny Enrollment and Revoke Medicare Billing Privileges