Saturday, December 12, 2009

have to curb fraud/abuse before expanding healthcare

While many healthcare providers are fair minded, they are possibly committing fraud through inappropriate billing and up coding. Throwing more government or private dollars at a system riddled with fraud and abuse makes NO sense. We MUST educate providers and do drop-in clinic audits to insure proper coding and billing is being done. I am seeing that the insurance dollar and medicare dollar is shrinking, so office administrators are getting more and more creative with "up coding" or mis-coding the actual service being rendered. I challenge the professional organizations of medical providers and professional educational programs to truly educate students and practitioners about the appropriate way to bill and code. Ignorance is REALLY NO EXCUSE!

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