The Centers for Medicare and Medicaid Services (CMS) recently introduced the Pre-Claim Review Demonstration, which is launching in states identified as having higher rates of fraud, abuse, and over-spending. This pre-claim demonstration was announced in addition to the seemingly constant regulation updates that are making 2016 one of the most interesting years for home health.
In this second part of our pre-claim review webinar series presented by Jennifer Gibson, we will look at the pre-claim review model and how Medicare Administrative Contractors (MACs) will carry out the pre-claim review process.
You will learn:
•The facts that led to pre-claim review
•The authority behind pre-claim review
• Some of the key triggers and red flags of improper billing and fraud
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