Health Law

Medicare Tracks Provider Inquiries

By Todd A. Rodriguez

If you have a question about Medicare coverage or how a particular service is to be billed, who do you call? Many physician practices don’t hesitate to pick up the phone and call their Medicare carrier provider representative for guidance. While this can be an effective way of getting certain kinds of questions answered, practices should be aware that their calls to the carrier are being tracked and can be used by the carrier for a variety of things, including initiating audits. A recent Medicare carrier transmittal, Instructions Related to the CMS Standardized Provider Inquiry Chart for FY 2008, updates instructions to carriers on tracking provider inquiries and increases the level of specificity with which those inquiries are to be tracked. To avoid landing on the carrier’s radar screen with potential compliance or billing concerns, therefore, it is generally advisable, with the assistance of legal counsel, to make Medicare inquiries only in writing and on an anonymous basis.

Full post as published by Physician Law on February 05, 2008 (boomark / email).