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Question: Healthcare Medical Insurance Processing Discussion Topic: Billing Audit Scenario You are a lead c…

Discussion Topic: Billing Audit Scenario in Healthcare Medical Insurance Processing You work for a large, successful internal medicine practice as a lead certified billing specialist. Ten physicians, three nurse practitioners (NPs), five medical assistants, and four billing and coding professionals make up the practice (including you). Your office manager has requested your assistance with the recent Medicare RAC audit, which is being undertaken on 75 randomly selected charts. You learn that two (2) of your veteran physicians and one (1) nurse practitioner have been invoicing for services that were not performed and/or upcoding visits totaling roughly $250,000. What will you do if you find out about this?