Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.
Payer Utilization Review
Almost all payers are scrutinizing the utilization of services in order to reduce costs. There are several documents that can be helpful in understanding the types of services drawing the most attention.
OIG Work Plan
The conventional wisdom about the effectiveness of billing compliance plans to avoid problems with fraud and abuse emphasizes the need to plan annual employee training based on important risk areas. An excellent source of updated information about potential risks in physician practices is the government reports that identify focus areas for investigation such as the Office of Inspector General (OIG) Work Plan and the program integrity initiatives developed by the Centers for Medicare & Medicaid Services (CMS).
- Medicare National Carrier Decisions
- MAC Local Coverage Decisions
- Newsletters from commercial payer websites
Urology practices must be diligent to remain aware of these issues or risk having prior payments recouped.
advertisement
advertisement