OIG Roundtable (Formerly Retro Fraud)

Episode 150: When Edits fail in In-Patient Claims


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Eric, Wade and Matt discuss a recent OIG study that found duplicate payments being made for certain DME products when the patient was in-patient.  This behavior permeates not only DME, but can also implicate other things such as medications.  We discuss the overall importance of having strong edits and how this type of review can greatly increase ROI, opportunity cost and reduce case backlogs by not needing to perform medical record reviews.

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OIG Roundtable (Formerly Retro Fraud)By Eric Rubenstein