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Medical billing BCBS NORTHEASTERN basicare COMM PA PO BOX 890062 CAMP HILL, PA 17089 800-829-8599 BCBS OF ALABAMA PO BOX 2294 BIRMINGHAM, AL 35201 800-517-6425 BCBS OF ALABAMA PO BOX 2298 BIRMINGHAM, AL 35201 800-517-6425 BCBS OF ALABAMA PO BOX 2294 BIRMINGHAM, AL 35201 877-779-6565 BCBS OF ARIZONA PO BOX 1200 PHOENIX, AZ 85001 800-232-2345 BCBS OF ARKANSAS PO BOX 2181 LITTLE ROCK, AR 72203 800-225-1891 BCBS OF ARKANSAS PO BOX 2181 LITTLE ROCK, AR 72203 800-827-4810 BCBS OF CENTRAL NY PO BOX 4782 SYRACUSE, NY 13221 800-920-8889 BCBS OF DE BLUE CHOICE PO BOX 8830 WILMINGTON, DE 19899 800-552-5356 BCBS OF FLORIDA PO BOX 1798 JAX, FL 32231 904-791-6111 basicare BCBS OF GEORGIA PO BOX 9907 COLUMBUS, GA 31908 800-441-2273 BCBS OF HAWAII PO BOX 44500 HONOLULU, HI 96804 808-948-6330 BCBS OF ILLINOIS PO BOX 1220 CHICAGO, IL 60690 800-635-9355 BCBS OF KANSAS basicare 1133 SW TOPEKA BLVD TOPEKA, KS 66629 800-432-3990 BCBS OF KANSAS 1133 SW TOPEKA BLVD TOPEKA,KS 66629 800-432-3990 BCBS OF KANSAS CITY PO BOX 419169 KANSAS CITY, MO 64141 800-892-6048 BCBS OF LOUISIANA P O BOX 98029 BATON ROUGE, LA 70898 800-258-3495 BCBS OF MASSACHUSETTS PO BOX 9196 NO QUINCY, MA 02171 800-227-7759 BCBS OF MASSACHUSETTS 100 NEWPORT AVE NO QUINCY, MA 02171 800-872-5298 BCBS OF MICHIGAN PO BOX 2888 DETROIT, MI 48231 800-637-2227 BCBS OF MICHIGAN PO BOX 2888 DETROIT, MI 48231 800-249-5103 BCBS OF MINNESOTA PO BOX 64338 ST PAUL, MN 55164 800-859-2126 BCBS OF MISSISSIPPI basicare PO BOX 1043 JACKSON, MS 39215 800-257-5825 BCBS OF MISSOURI 1831 CHESTNUT ST LOUIS, MO 63103 800-892-6048 BCBS OF MONTANA PO BOX 5004 GREAT FALLS, MT 59403 800-447-7828 BCBS OF NEBRASKA
Video: Medical Billing Tips – Coding for Medicare Flu Shots
OLReporter: Medicare, Fraud: Providers Most Commonly Caught
In October 2012, the General Accountability Office (GAO ) reported to Congress on its study of the most common sources of fraudulent activities (both criminal and civil) among Medicare program participants. According to the GAO, medical facilities such as medical centers, clinics, and practices, and durable medical equipment suppliers were the most frequent subjects of criminal fraud cases in 2010. More than a quarter of the criminal prosecutions involved health centers; durable medical suppliers made up another 16%. These groups were the subjects in 20% and 18% of the civil actions, respectively. A very small percentage of fraud cases were brought against individual Medicare recipients. Common health care fraud schemes include providers or suppliers (1) billing for services or supplies not provided or not medically necessary, (2) purposely billing for a higher level of service than that provided, (3) misreporting data to increase payments, (4) paying kickbacks to providers for referring beneficiaries for specific services or to certain entities, or (5) stealing providers’ or beneficiaries’ identities.
Optomotrist Busted for Medicaid Fraud
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Federal Government Claims Nursing Homes Overbilled Medicare
A recent study by the inspector general’s office of the Department of Health and Human Services concluded that hundreds of nursing homes billed about a quarter of claims incorrectly in 2009. The report is part of a years-long initiative by the Department of Health and Human Services to rein in costs at the 15,000 nursing homes that provide skilled nursing. Most of those claims were “upcoded,” which means Medicare was billed for services that were more extensive than what was provided or needed. Many of the claims were for intensive physical speech or occupational therapy.
The Grumpy Economist: Billing codes
A while ago, an acquaintance saw her dermatologist for an annual check. She said, “oh, by the way, take a look at the place on my foot where we removed a wart a while ago.” The doctor looked at her foot, said everything is fine, then finished the exam. Checking the bill, there was a $400 extra charge for the wart examination! This nice audio story from NPRs “third coast festival” tells the story of billing codes. Answer: As insurers and medicare/medicaid reduce payment for services, doctors respond by writing up every billing code they legally can. There are whole conferences devoted to billing code maximization. It’s a lovely unintended-consequences story. Good luck with that “cost control.” The piece quotes the Institute of Medicine that there are 2.2 people doing billing for every doctor, at a $360 billion dollar cost. I couldn’t find the source of these numbers. If any of you can, post a comment. Of course, being NPR, the program leaves the impression that all this will be fixed in our brave new world of the ACA. But it wasn’t even that heavy handed on the point. Perhaps experience is gaining on hope.