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March 2008
Sherri is the manager of a busy UMG clinic in which many types of procedures are performed. The clinic uses a voucher system to charge for its services. In reviewing a group of
vouchers Sherri notices that one of the vouchers has been completed incorrectly by Dr. Jones. When Sherri inquires, Dr. Jones tells Sherri that this is the way that she always completes
the voucher for this particular procedure. Sherri is concerned that this procedure may have been billed incorrectly for several months.
What are the implications of this quandary? What should Sherri do?
Things to Consider
The possibility that UMG has incorrectly billed for this procedure has many implications. Inaccurate billing may result in an overpayment or underpayment by a federal or other
healthcare insurance program. Overpayment may require refunding money to the payor while underpayment may mean that opportunities for revenue have been missed. Both overpayments and
underpayments may result in a more detailed audit by the healthcare insurance program.
Since Sherri has knowledge of an error that may result in incorrect billing she should notify her supervisor, the Compliance Office at 860-679-4180 or
compliance.officer@uchc.edu, or contact the UConn Health Center REPORTLINE at 1-888-685-2637. Informing the appropriate individuals with
as many details about the issue as possible ensures that the concern will be thoroughly reviewed by the UConn Health Center and that proper actions can be taken and corrections made.
It is everyone’s responsibility to contribute to the UConn Health Center’s ongoing compliance with today’s complex and often changing regulations by ensuring the accurate completion
of vouchers, providing appropriate supporting documentation, and bringing forward any questions or concerns.
For more information please refer to UConn Health Center Policy # 2007-12 Determination, Reporting, Investigation
and Correction of Errors Related to Reimbursement from Federal or other Healthcare Insurance Programs (PDF). |
