Understanding the Red Flag Rules - Log in - American Health ...
Understanding the Red Flag Rules - Log in - American Health ...
Understanding the Red Flag Rules - Log in - American Health ...
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<strong>Understand<strong>in</strong>g</strong> <strong>the</strong> <strong>Red</strong> <strong>Flag</strong> <strong>Rules</strong><br />
Notes/Comments/Questions<br />
<strong>Red</strong> <strong>Flag</strong>s for <strong>Health</strong>care Providers<br />
• Patient concern regard<strong>in</strong>g receipt of<br />
bills for services not provided or for<br />
ano<strong>the</strong>r <strong>in</strong>dividual<br />
• Inconsistent <strong>in</strong>formation <strong>in</strong> health<br />
records (patient profile does not<br />
match)<br />
15<br />
<strong>Red</strong> <strong>Flag</strong>s for <strong>Health</strong>care Providers<br />
–cont<strong>in</strong>ued<br />
• Notices of <strong>in</strong>vestigation from<br />
<strong>in</strong>surance companies for fraud<br />
• Collection notices to patients for<br />
services <strong>the</strong>y did not receive<br />
• O<strong>the</strong>r “suspicious” behavior<br />
16<br />
AHIMA 2009 Audio Sem<strong>in</strong>ar Series 8
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