Posted and filed under Compliance, FWA.

Clinical Labs Under Heavy Scrutiny After Cigna Lawsuit

A tidal wave of fraud has been approaching our shores for quite some time, and it’s finally broken land. The scheme, gaining popularity in clinical labs and pathology groups involves waiving patient fees and copays in order to send payer groups inflated claims fees. While these billing tactics might seem innocuous, they are fraudulent because…

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Posted and filed under Compliance, Payers.
physician arms crossed

Quality Measuring Tools for Payers

How important is quality to you? For most people, quality – which equates to a measure of excellence and meeting strict standards – is one of the most important factors in most decision-making related to consumer goods and products. Take the automobile industry; businessdictionary.com uses the example that “if an automobile company finds a defect…

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