HCFA cracks down on MD billing number scams
HCFA cracks down on MD billing number scams
Do you know where your physician billing number is and who is using it?
The fraud cops at HCFA are stepping up efforts to stamp out the growing abuse of reassigned physician billing numbers.
This also means HCFA is going to get tougher on enforcing existing rules requiring that physicians know who is billing what services in their name.
Even if you have done nothing wrong yourself, if your physician billing number is inappropriately used you can still be penalized for poor record keeping.
Physicians sometimes have a legitimate need to reassign their billing numbers to clinics where they provide care, HCFA acknowledges. How ever, when such reassignments are abused by using a billing number to submit claims for care that have not been provided - even without the physician's knowledge - odds are the provider is still going to get into some kind of trouble with HCFA for not keeping better track of their billing number.
Targeted Medicare reviews of physicians in Florida with multiple reassignment arrangements, for instance, found some clinics were submitting claims under billing numbers of physicians who had not worked at their clinic in more than two years. In other cases, claims were being submitted for care provided on the same day under identical physician billing numbers from clinics hundreds of miles apart.
"These kinds of abuses have to be stopped. I am determined to do something about it," says HCFA Administrator Nancy Ann Min-DeParle.
In turn, HCFA will be performing nationwide targeted reviews of physicians with large numbers of reassignments. Medicare is also considering limiting the number of reassignments a physician can make as a way to deter such abuse.
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