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Guidelines to protect your practice from fraudulent billing
Medicare has created a list of fraudulent or unacceptable billing practices that may result in a referral to the Office of Inspector General for criminal, civil, or administrative action. Although this report is based on Medicare compliance guidelines, these guidelines are applicable to other third-party payers. The areas of fraudulent billing to be discussed are billing under another provider's number, "incident to," signature on file, advanced beneficiary notices (ABN) using the GA modifier, documentation in chart, and patient identity theft.