8. Know what is being billed in your name, particularly by a third party, since you are responsible for it even if you never receive a payment (by virtue of being on salary).
To help combat fraud and abuse, PAs and NPs must become more knowledgeable about what the billing process entails. This should be part of the curriculum in school. Although it is a complex and difficult system (especially with ICD-10 coming sooner or later), there has to be rudimentary understanding to avoid traps.
Have I overreacted? We would love to hear additional ways to avoid fraud and/or experiences with billing that you would like to share for the benefit of our readers. You can contact me at PAEditor@qhc.com.
REFERENCES
1. Centers for Medicare and Medicaid Services. Medicare Fraud and Abuse: Prevention, Detection, and Reporting. Available at: www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Fraud_and_Abuse.pdf. Accessed August 15, 2012.
2. Buppert C. Avoiding Medicare fraud, part 1. Nurse Pract. 2001;26(1):70, 72-75.
3. Buppert C. Avoiding Medicare fraud, part 2. Nurse Pract. 2001;26(2):34-38, 41.
4. Medicare 101 for PAs: Understanding Billing [podcast]. Available at: www.reachmd.com/xmsegment.aspx?sid=5782. Accessed August 15, 2012.