Pressured to provide access to affordable healthcare to a growing number of Americans, the Feds are pursuing billions wasted annually in healthcare through aggressive government and commercial payer audits.
While commonly referred to as “fraud prevention efforts”, the allegations in these audits are rarely fraud or abuse.
Rather, the allegations are more subjective in nature, leaving every healthcare provider vulnerable to accusations of improper billing by the CMS, involving:
*Other (incorrect discharge status or transfers, incorrect payment amounts, etc. – 17% of errors)