I know that when we deal with outside vendors for coding, our contracts state that we (the client) are still responsible for making sure the claims are correct.
So here is the scenario I am not so clear on.
If you use a billing company, they provide the software, your staff enters in the information, then they are responsible for filing the claims and doing the follow-up.
They get paid a percentage based on what they collect for you. What happens if they change the information you entered in their system, in order to get paid, thereby creating fraudulent claims?
Is the provider still responsible or is the billing company held liable?
I keep up with the OIG goings on as much as possible and I can't recall ever seeing this type of situation addressed.
I like to know all the ins and outs before I get involved with other companies.
Thanks for any input,
Laura, CPC, CEMC
So here is the scenario I am not so clear on.
If you use a billing company, they provide the software, your staff enters in the information, then they are responsible for filing the claims and doing the follow-up.
They get paid a percentage based on what they collect for you. What happens if they change the information you entered in their system, in order to get paid, thereby creating fraudulent claims?
Is the provider still responsible or is the billing company held liable?
I keep up with the OIG goings on as much as possible and I can't recall ever seeing this type of situation addressed.
I like to know all the ins and outs before I get involved with other companies.
Thanks for any input,
Laura, CPC, CEMC