OIG Workplan

Written by Reed Tinsley, CPA | July 5, 2005

Did you know the following physician issues were included on the OIG (Office of Inspector General) work plan?

  1. Billing Service Companies – Review of incentives to up code and over bill.
  2. 99374 – 99380 – Care Plan Oversight – I’d see if any of your docs are billing this.  There are certain criteria that must be met which is the review underway.
  3. Physician Pathology Services – reviewing the relationship between the pathologist and the ordering physician.
  4. E&M Coding – Determining if outliers are being appropriately reviewed.
  5. Use of 25 and 59 Modifiers – Review of appropriateness
  6. Provider Based entities – Review of site of service for entieis that may be billing as office but should be facility billing.

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.

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