Medical Coding Fraud Claims: What You Need to Know to Stay Safe

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Күн бұрын

Пікірлер: 14

@MsBrownie231 Жыл бұрын

Thanks Victoria for these tips! Recently passed the CPC test and being compliant is so important to me. So excited to find a position to utilize these new skills.

@jenniferflores4 Жыл бұрын

Great tips as a new coder this is so helpful. I used to work in a facility that had fraud going on and I found out one day when I walked in and was told the FBI came in and arrested someone in the administration department! Took him out in handcuffs.

@johnali287 Жыл бұрын

Fraud occurs when a biller has no good knowledge about the coding. Even though you discussed the bundled CPTs, it can be resolved after the denials but it could be added correctly when we do submit the claims. Thanks for sharing such a video because many people take it easy but your video can be helpful for all those.

@newkindofwarfare Жыл бұрын

As someone who wants to be a Medical Coder, thank you so much for these videos! These are so helpful and help calm my anxiety about some how i’m going to accidentally cause the biggest issue in coding that’s ever existed. 😂

@lizthecontentcreator 11 ай бұрын

While a paitent was disputing charges I discovered that the practice I previously worked at was upcoding a patient where the code include/ required DME & the patient was never provided any medical equipment. In the process of attempting to report the practice, they were requesting specific patient examples & I wasn't sure how to submit evidence without breaking HIPPA laws. However, I did bring my concerns to my supervisor & the specific coder who is supposed audit the physicians code selection. Nothing was ever done & it was a known ongoing issue within the practice.

@Al-rn5qy Жыл бұрын

Thanks for an amazing video, Victoria. I love your cake 🍰 analogy when it comes to unbundling. So true, can you imagine being charged the full price of a cake, then charged extra for flour, eggs, etc !😂 Of course the cake price already includes the ingredients and labor for making it and most customers would think that's fraud to be charged additionally for these. I have to use this analogy when explaining to lay people about our regulations.

@mossegaming 9 ай бұрын

Great information! I am a fraud auditor, and we see a lot of people that try to code "around" insurance code edits to avoid auditing by purposely misusing modifiers. And yes, lots of unbundling!

@GO-nh6br 7 ай бұрын

Exellent now i know about the 5 main codes, instead of being coded for code 2 got coded 3, to be bill higher, i found this information on the blue croos blue shield..codes page.my daughter had a strain dumb, doctor saw her send her home with no medicine or follow up..just told her put ice....the bill was over $2400...yeah right..

@gabrielaherrera3665 Жыл бұрын

This was so informative thank you so much. More if these please ❤

@porshianbrown2061 Жыл бұрын

Thank you Victoria for these helpful tip. Do you know if some of this information will be on the CPC exam? I'm so nervous about this exam I think I'm over thinking things.