Fraud and Abuse
Mistakes Occur - When is It Fraud?
The Centers for Medicare & Medicaid Services provide the following definition: "Fraud is an intentional representation that an individual knows to be false or does not believe to be true and makes, knowing that the representation could result in some unauthorized benefit to himself/herself or some other person." If an error is made in "good faith" or without the intent of providing false information, it is considered a mistake. If a mistake occurs, payments made erroneously will be requested to be returned; however, no penalties are assessed. Those who submit Medicare claims are responsible for utilizing educational resources that are available (e.g. on-line tutorials, Medicare e-News, reading materials, and seminars) in order to avoid billing mistakes. Providers taking a proactive stance towards billing correctly by self-assessing billing practices and researching billing tools will save time and avoid unnecessary costs to the practice and to the Medicare program.
For more information on Medicare fraud and abuse please select this link .
Page Last Updated: Tuesday, 04-Dec-2007 13:19:26 CST
