Special Topics in Computer Information Systems. This is an introductory-level course with content that varies.
Third Party Billing Company Fraud: HBMA is a voluntary membership organization and the only trade association representing third-party medical billing companies.
On behalf of HBMA, I would like to thank the Committee for the opportunity to appear today to address your interest in developing methods to identify those who submit claims to federally sponsored healthcare programs. We are pleased that the Computerizaiton enrollment Committee, in addition to its responsibilities regarding oversight of Computerizaiton enrollment, is also responsible for the Small Business Administration, since almost all of our members are small businesses.
A one-page profile of our membership is included at the end of our written testimony. Indeed, HBMA takes great pride in our compliance activities, putting us in the forefront of efforts to prevent fraud and abuse in the third party billing industry. Let me begin by emphasizing that the HBMA strongly supports the goal of protecting the integrity of Medicare and other federally funded health care programs.
The response to this program from the third party billing community has been overwhelming. Each of the three conferences presented in sold-out; the first presentation for has already shown strong registration.
We are pleased to report that several hundred third party billing companies have completed our courses in spite of the fact that the registration fee is more than seven times the fee for our regular educational meetings.
Our compliance course specifically discusses the need for third party billing companies to be aware of the potential that criminal enterprises, intent on generating fraudulent Medicare claims, may seek out legitimate third party billers to serve as a front for their criminal enterprise.
It appears that the conduct cited earlier is exactly such a case. Our goal, and we believe the goal of this Committee, is to reasonably reduce the extent to which this can happen and create a mechanism where auditors can more readily detect those instances of fraudulent billing that may occur.
With two compliance programs at work, the chances of errors, as well as deliberate misconduct are sharply reduced. We are happy to report that such arrangements already exist and are a growing trend as our members encourage their clients to develop and implement their own compliance programs.
It is also important, Mr. Chairman, as we engage in this dialogue on how to prevent fraudulent billing, that we do so with an understanding that no matter how creative we may be in establishing mechanisms for the prevention and detection of fraud, we realize we will never eliminate deliberate billing fraud.
The simple reason is that the creativity of the criminal mind knows no bounds. Just as sophisticated bank vaults do not stop determined bank robbers from their crimes, no system of registration, auditing or oversight, will prevent a criminal from defrauding Medicare. This is important, as the issue is far more complex than it would appear to the layman.
Certainly, a separately incorporated company offering billing services is a billing company. What about the medical practice that, for tax reasons, has incorporated its own billing office under another identity?
What about hospital-owned practices, billed by the hospital under the identity of its MSO Management Service Organization? What about insurers who own practice s and provide billing?
And, of course, what about the Practice Plan providing centralized or de-centralized billing support for medical school faculty? It is impossible to anticipate the number of combinations and variations of claims handling: Listed below are some of the aspects of this potential process that we consider potentially problematic: By whom would billers be registered?
HCFA, the Carrier sor another central source?The CMS A Medicare Enrollment Application - Institutional Providers form is available on the CMS web site.
You will be notified whether you are eligible for the RHC program after your applications (the number of applications depends on your state) have been processed.
If eligible, the next step is the RHC Certification inspection. The role of AOLIS is to make work and life easier by automation, computerization, simplification of processes, and documentation of workflows and other organizational - functional information, so that the AUP workforce can focus more on the more important work of soul winning.
Computerizaiton Enrollment. effort to upgrade the enrollment process and to solve some observe problem as long quizzes, economic burdens, etc.
Bago City College launched the computerization of the enrollment process for Academic Year which was implemented by enrollees for incoming First Year Students and Transferees.
Dixie became Dixie State University and had to move from NJCAA to NCAA status in athletics. Enrollment grew dramatically to , then 8,, then to over 9, Many four-year programs were added to the curriculum by , including 22 new bachelor’s degrees. Computerization of Medical Practices for the Enhancement of Therapeutic Effectiveness (COMPETE III) The safety and scientific validity of this study is the responsibility of .
Augmentation of ICT equipment for schools with huge enrollment shall be provided based on enrollment. For Secondary Schools with 9, and above student population, they shall receive terminals. Secondary Schools with 5,, enrollees .