MEDICARE: Using Education and Claims Scrutiny to Minimize Physician Billing Errors

Abstract

The discussion of the challenges physicians and the Medicare program face in ensuring that claims for physician services are billed and paid appropriately. The General Accounting Office, an agency within the legislative branch that monitors the effectiveness and efficiency of federal programs for the Congress, has conducted oversight of the Medicare program for many years. With annual fee-for-service payments now totaling about $192 billion, the Centers for Medicare and Medicaid Services (CMS), the agency responsible for administering Medicare, has an important responsibility to safeguard payments for health services delivered to elderly and disabled individuals by hundreds of thousands of providers. In its most recent audit, covering fiscal year 2001, the Department of Health and Human Services (HHS) Office of Inspector General found that $12.1 billion, or about 6.3 percent of fee-for-service payments, was improperly paid to Medicare providers.

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Document Details

Document Type
Technical Report
Publication Date
May 28, 2002
Accession Number
ADA401892

Entities

Organizations

  • United States Government Accountability Office

Tags

DTIC Thesaurus Topics

  • Accounting
  • Best Practices
  • California
  • Clinical Laboratories
  • Congress
  • Customer Services
  • Education
  • Errors
  • Health Care
  • Health Services
  • Medicare
  • New York
  • Physicians
  • United States
  • Websites
  • West Virginia
  • Wisconsin

Fields of Study

  • Medicine
  • Political science

Readers

  • Defense Acquisition Program Management
  • Medical or Health Care Field.