Medical Billing Audits performed by Medicare, Medicaid, and commercial payers have significantly increased in frequency in recent years and will continue for the foreseeable future. No specialty is immune from these risk adjustment audits, with pre and/or post payment demands that can be in the millions. This can seriously impact a physician’s cash flow, practice, and ability to stay in business.
A “red flag” trend identified by Conventus as a precursor to these audits is billing for non-physician practitioner (NPP) services without the NPP being credentialed with the insurance carrier. NPPs are practitioners such as physician assistants . . .
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