New studies show EHRs do not lead to fraudulent charges

Jul 9, 2014 | Uncategorized

When the federal government began incentivizing the use of electronic health records (EHRs), many health care industry experts were concerned for their potential for abuse of the Medicare system. There was a real concern being shared that moving coding and billing practices into a fully digital realm would lead to widespread fraudulent claims.

According to Kaiser Health News, the Departments of Justice and Health and Human Services were concerned enough about the prospect to send hospitals a "strongly worded" letter warning them against using electronic records inappropriately.

Now, with the release of a new study from the University of Michigan School of Information and the Harvard School of Public health, these fears may have been proven unfounded. The study, published in the online July issue of Health Affairs, looked at hospitals that would be likely to change their coding practices: for-profit hospitals, hospitals in competitive markets, and hospitals with a substantial proportion of Medicare patients, and found no evidence to suggest systemic abuse of the systems. 

"There have been a lot of anecdotes and individual cases of hospitals using electronic health records in fraudulent ways. Therefore there was an assumption that this was happening systematically, but we find that it isn't," Adler-Milstein, assistant professor of health management and policy in the U-M School of Public Health, told the source.

Abuse of Medicare billing codes, such as "upcoding", where providers overcharge for services, can greatly affect a care center that relies on reimbursement ability to provide quality patient care. While it can be tempting to try and increase reimbursements, being charged with Medicare fraud can greatly affect a facility's reputation and financial standing. 

If your practice is looking to run a more efficient and effective accounts receivable department, Professional Medical Services can help you clear up these outstanding accounts with the utmost efficiency by using a combination of automated tools and knowledgeable staff.