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Advancements in A.I. are Combating Healthcare Fraud

Advancements in A.I. are Combating Healthcare Fraud

The National Health Care Anti-Fraud Association estimated that healthcare fraud costs the nation $68 billion annually. (BCBS, n.d.) An article on the Physicians Practice website published February 18, 2021, stated, “In January 2020, the U.S. Justice Department reported that over $2.6 billion had been recovered from lawsuits relating to medical fraud.

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2005 Legislation

2005 Legislation

Six thousand two hundred and nine (6,209). That is the number of bills introduced by your Representatives and Senators in Illinois in 2005. Of those bills, 95 affected chiropractic in one way or another. These bills attempted to affect many issues from Physical Therapy changes to ultrasound limitations, from medical malpractice reform to workers compensation revisions.

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Avoid Duplication of Diagnoses​

Avoid Duplication of Diagnoses​

Although multiple segments or regions may be involved in the cause of a patient’s ailment, it is important to identify the main segment or region and report the diagnosis specifically. Medicare has recently reaffirmed that duplication of diagnoses in Box 21 on the claim form will be denied. Each area treated must have a unique diagnosis.

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Associate Physician Departing from Practice – Legal Considerations

Associate Physician Departing from Practice – Legal Considerations

The departure of an associate physician from a practice sometimes causes operational disruption and always requires the practice and the departing associate to take steps to ensure a smooth transition. Both the associate and practice need to address the ethical, regulatory, contractual, managed care, and liability impact of the exit.

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