fraud

Medical record requests by payors are commonplace for health care providers. Typically, these requests are received by a front desk employee who responds to the inquiry in short order.  Yet,
Continue Reading THE ABC’S OF THE S.I.U.: What Providers Need to Know

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

Federal prosecutors continue to focus their efforts on preventing health care fraud, as evidenced by a recent case arising in Texas. Earlier this year, a Houston doctor (Dr. Christina Clardy) was convicted of three counts of mail fraud, 14 counts of health care fraud and one count of conspiracy to commit health care fraud – all relating to over $45 million in false billings to Medicare and Texas’ Medicaid programs.
Continue Reading Federal Prosecutors Continue Focus On Health Care Fraud