Medical Billing Normalization Comparisons

Understanding Medical Billing Invoice Variations Staff Reporters Deviations in medical billing may often be detected through utilization data that the government or private insurance companies produce on all providers that submit a claim for payment of services. Uncle Sam and insurance companies track utilization through a variety of parameters, including CPT codes, ICD-9-CM, or number [...]

Healthcare Fraud versus Healthcare Abuse

Understanding Definitional Semantics Staff Reporters Fraud Defined Fraud may be defined as any illegal healthcare activity where someone obtains something of value without paying for, or earning it. In healthcare, this usually occurs when someone bills for services not provided by the physician. Abuse Defined According to the www.HealthDictionarySeries.com, healthcare abuse is the activity where [...]