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Category: How To

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Acupuncture Billing / How To

SOAP Notes: The Right Way

Learn how to prepare your SOAP notes correctly and avoid pesky claim denials.

How To

Dual Coverage: A Tale of Two Policies

Some patients have multiple insurance policies. Which one is billed first?

Acupuncture Billing / How To

PIP Tips: Billing Advice for Personal Injury Protection Claims (Motor Vehicle Accidents and Workers’ Comp)

PIP claims require special attention and handling. These 6 tips will help you file MVA and WC claims like a pro!

About Fraud, Waste, and Abuse (FWA)

Fraud is generally defined as knowingly and willfully executing, or attempting to execute, a scheme or artifice to defraud any healthcare benefit program or to obtain (by means of false or fraudulent pretenses, representations or promises) any of the money or property owned by, or under the custody or control of, any healthcare benefit program. (18 U.S.C. § 1347)

Waste is overutilization of services or other practices that, directly or indirectly, result in unnecessary costs to the healthcare system, including the Medicare and Medicaid programs. It is not generally considered to be caused by criminally negligent actions, but by the misuse of resources.

Abuse is payment for items or services when there is no legal entitlement to that payment and the individual or entity has not knowingly and/or intentionally misrepresented facts to obtain payment.

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