Detecting potential overbilling in Medicare reimbursement via hours worked

Detecting potential overbilling in Medicare reimbursement via hours worked

Collection:
Health Policy and Services Research
Series Title(s):
Research brief (Leonard Davis Institute of Health Economics)
Author(s):
Fang, Hanming, author
Gong, Qing, author
Contributor(s):
Leonard Davis Institute of Health Economics, issuing body.
Publication:
Philadelphia, PA : Leonard Davis Institute of Health Economics, 2016
Language(s):
English
Format:
Text
Subject(s):
Financial Audit -- methods
Fraud -- prevention & control
Insurance, Health, Reimbursement -- economics
Medicare Part B -- economics
United States
Genre(s):
Technical Report
Abstract:
KEY FINDINGS: Almost 3% of physicians who serve Medicare Part B Fee-for-Service (FFS) patients bill Medicare for services that would take more than 100 hours per week to provide--an implausible number--in this novel and easy-to-implement approach to detect potential overbilling based on the hours implied by actual billing codes.
Copyright:
Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
Extent:
1 online resource (1 PDF file (2 pages))
Illustrations:
Illustrations
NLM Unique ID:
101683944 (See catalog record)
Permanent Link:
http://resource.nlm.nih.gov/101683944