Insurance audits: Physicians on the menu

April 30, 2011 by Hayes H. Wanamaker, MD
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Guest Editorial

As costs in the healthcare system continue to rise, guess where both private carriers and the government are looking for more money? Buried within the contracts that we all sign with government payers such as Medicare and Medicaid, as well as private payers such as Aetna, Cigna, and the Blue Cross Blue Shield plans are provisions allowing for audits.  

As costs in the healthcare system continue to rise, guess where both private carriers and the government are looking for more money? Buried within the contracts that we all sign with government payers such as Medicare and Medicaid, as well as private payers such as Aetna, Cigna, and the Blue Cross Blue Shield plans are provisions allowing for audits. These provisions allow the carrier to review our patient records and documentation.

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