Navigation Links Offers Effective Ways to Combat Healthcare Fraud and Abuse in California, Florida, and Michigan

WILMINGTON, Delaware, October 3, 2011 /PRNewswire/ --

Medical fraud and abuse is the most profitable healthcare crime in the US, and a string of recent high-profile cases in medical fraud in California, Florida, and Michigan have once again catapulted the topic center stage.

The US healthcare reimbursement is contextualized in a plethora of stringent and complex billing and coding regimen and, ironically, that itself makes it vulnerable to potential abuse, fraud, and waste by its various stakeholders. According to a report by Thomson Reuters, the US healthcare system wastes around $505-$850 billion every year, out of which the waste caused due to fraud and abuse constitutes $200 billion, or 22% of healthcare waste every year.

California medical billingFlorida medical billingMichigan medical billing

What are the most effective ways of handling this revenue loss in an industry that consumes nearly 16% of the national GDP?

This is precisely the area where the third party billing companies can come to the aid of healthcare providers. Billing companies play a crucial role in assisting physicians in processing claims in accordance with applicable regulations. Apart from that, they provide timely and accurate advice vis-à-vis reimbursement issues as well as overall business decision-making. Further, individual medical billing and coding companies cater to a variety of providers with different specialties and can therefore play a pro-active role in establishing and ensuring compliance responsibilities with their clients.

MBC, the largest consortium of billers and coders in the US, catering to billing and other reimbursement requirements of healthcare providers across all specialties, can effectively stimulate the efforts to stem fraud and abuse in California, Florida, and Michigan as well as most other states. It can play a significant role in validating the compliance norms through authentic and responsible implementation of healthcare policies, procedures, and standards of conduct including HIPAA, ICD-9, and CPT coding systems through the routine operations of its provider-clients.

Moreover, the ensuing healthcare changes including ICD-10 and HIPAA 5010 are aimed at actively reducing abuse and discrepancies in medical claims by making the coding process more detailed and transparent; the electronic submission will make it more accessible and open to audit scrutiny. In the wake of these imminent changes, MBC experts can minutely scrutinize the various stages of revenue cycle management to identify the precise root causes of revenue inefficiencies and abuse at various levels to put your clinic in order to pre-empt the onslaught of ICD-10.

MBC Expertise in Handling Healthcare Fraud & Abuse

Reimbursement and payment areas, particularly claims and billing, are often the source of medical abuse and fraud. Medical billers and coders - AAPC-certified, experienced in dealing with individual physicians, multispecialty groups, hospitals, and diagnostic centers across the nation, substantial experience of working with Recovery Audit Contractors (RACs), and carrying consistently upgraded skill-set and knowledge of healthcare regulations - can effectively identify and assess the areas of inefficiencies, misuse, and wastage to streamline your RCM.

Their areas of expertise include the following:

  • Provide critical advice to physicians to improve the quality of their clinical documentation
  • Streamline the internal processes in keeping with the latest healthcare compliance policies and regulations
  • Respond promptly to identified non-compliances with corrective action
  • Establish effective norms amongst the physician staff to promote the prevention, detection, and resolution of non-compliance cases
  • Effective handling of RAC audits in case of one

In a proactive environment aimed at beating fraud and abuse in the healthcare industry, "Our consultancy services are geared to establish the entire gamut of compliance norms as well as to create awareness about the potential legal and ethical consequences of inadvertent non-compliance," says the President,, "We suggest and implement procedures in clinic's to ensure that all stakeholders of healthcare run profitable enterprises and healthcare all together is fair and affordable."

About is the largest 'Consortium of Medical Billers and Coders,' across the US. The portal brings together hundreds of billers, with experience in different specialties, on the same platform to service physicians in their local areas. This network of coders and billers is growing rapidly and is currently servicing over 50 specialty physicians, across the US ( Montana medical billingWisconsin medical billingMaine medical billingColorado medical billingLas vegas medical billingMiami medical billingTampa medical billing ), with the most prominent being Medical billing radiologyMedical billing chiropracticMedical billing physical therapy and General Practice.

Prerna Gupta, Media Relations
108 West, 13th street,
Wilmington, DE 19801
Tel: +1-888-357-3226
Medical Billing Blog

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