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Education Required to Reduce ErrorsBilling for physicians, hospitalizations, home health agencies, durable medical equipment suppliers, and other health care providers were studied in a recent report that allocated dollar amounts made in payment errors. Errors were estimated at $12 billion in 1998. The report stated that the three major category errors in claim submissions and payments, in order of dollar amount, were: Documentation errors - $5.5 billion; Lack of medical necessity - $4.4 billion; and, Coding errors - $2.1 billion. Physicians account for $1.1 billion for documentation errors; $0.1 billion for medical necessity errors; and $1.5 for coding errors, for a reported share of $2.7 billion in the total amount that was reimbursed incorrectly during that period. HCFA is now stressing that greater educational efforts must be made to the medical community. Medicare contractors will be required to make local regional medical policies assessable on the Internet and documentation requirements for Evaluation and Management services will likely be revised, and hopefully simplified, within the near future.
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