Medicare: Using Education and Claims Scrutiny to Minimize Physician Billing Errors

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Testimony issued by the General Accounting Office with an abstract that begins "In its audit for year 2001, the Department of Health and Human Services' Office of Inspector General found that $12.1 billion was improperly paid to Medicare providers. GAO's February report (GAO-02-249) showed that physicians often do not receive complete, accurate, clear, or timely guidance on Medicare billing and payment policies. At the carriers studied, GAO found significant shortcomings in printed material, web sites, and telephone help lines used to provide information and respond to physicians' questions. GAO concluded the Centers for Medicare and Medicaid Services (CMS) needed to ... continued below

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United States. General Accounting Office. May 28, 2002.

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Testimony issued by the General Accounting Office with an abstract that begins "In its audit for year 2001, the Department of Health and Human Services' Office of Inspector General found that $12.1 billion was improperly paid to Medicare providers. GAO's February report (GAO-02-249) showed that physicians often do not receive complete, accurate, clear, or timely guidance on Medicare billing and payment policies. At the carriers studied, GAO found significant shortcomings in printed material, web sites, and telephone help lines used to provide information and respond to physicians' questions. GAO concluded the Centers for Medicare and Medicaid Services (CMS) needed to initiate a more centralized and coordinated approach and provide technical assistance to carriers to improve provider communications. In fiscal year 2001, CMS revised its policy on conducting medical reviews. The policy directs carriers to differentiate among levels of billing problems and tailor corrective actions accordingly. As a result of this and other medical review modifications, the highest overpayment amounts assessed a physician practice by a carrier dropped substantially."

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Government Accountability Office Reports

The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for the U.S. Congress investigating how the federal government spends taxpayers' money. Its goal is to increase accountability and improve the performance of the federal government. The Government Accountability Office Reports Collection consists of over 13,000 documents on a variety of topics ranging from fiscal issues to international affairs.

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  • May 28, 2002

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  • June 10, 2014, 6:42 a.m.

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United States. General Accounting Office. Medicare: Using Education and Claims Scrutiny to Minimize Physician Billing Errors, text, May 28, 2002; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc289691/: accessed December 13, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.