Remove Article Remove Fraud Remove Medical Billing Remove Overpayment
article thumbnail

Navigating CMS UPIC Audits: A Guide for Healthcare Organizations

Compliancy Group

CMS UPIC audits are designed to identify and prevent fraud, waste, and abuse within Medicare and Medicaid, ensuring that federal funds are used appropriately and that the services billed for are actually provided and are medically necessary. Who Should Be Concerned About CMS UPIC Audits?

Fraud 52
article thumbnail

Preparing for Payer Coding Audits

Medisys Compliance

In this article, we shared some basic guidelines and recent trends in medical audits and what providers can expect in such payer coding audits. These are usually just innocuous mistakes that do not represent any intent to commit billing fraud. What just happened? How could they do this? Can they legally do this?