EHR fraud prevention: What providers, payers must know

By Marla Durben Hirsch

Simply using an electronic health record does not necessarily lead to billing fraud. But some of their functionalities, meant to create efficiencies, can lead to documentation that causes improper billing, as well as outright fraud. The U.S. Department of Health and Human Services' Office of Inspector General has vowed to crack down on EHR-enabled fraud, highlighting the issue in its 2014 work plan and chastising the Centers for Medicare & Medicaid Services for being lax about dealing with the problem.

"EHR fraud is as prevalent as non-EHR fraud," warns Dan Bowerman, a chiropractor in Philadelphia formerly with a large payer's special investigations unit who now works regularly with OIG, the Federal Bureau of Investigation and other government entities to uncover healthcare billing fraud.

So how can providers root out EHR-related documentation issues and fraud before it occurs? And what steps can private payers take to ferret out improper claims?

Read through the full FierceEMR special report to learn more. Click on any of the links below to continue.

EHR fraud prevention: What providers, payers must know