Auditing Antics: Navigating Medical Coding and Auditing
This episode takes a closer look at one of the most common and dangerous billing issues in healthcare operations: reporting services under the wrong provider’s NPI. What may seem like a simple administrative shortcut can quickly turn into a significant compliance problem when the documentation, supervision, credentialing, or actual rendering practitioner do not match the claim. In this episode, I break down why billing under the wrong provider creates exposure far beyond a claim correction, including audit risk, overpayment liability, false claim concerns, and payer scrutiny around who actually performed and supervised the service. I also walk through the operational habits that often lead to these errors, how organizations confuse billing rules with staffing convenience, and what practices should be reviewing now to make sure their claims accurately reflect the practitioner who performed the work.
62 episodios
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