FAQs

CPR Analysts answers the important questions.

Scope of the problem:

Q: How severe is the problem of coding and physician reimbursement?

A: It is incredibly severe. A government study revealed an improper claim submission rate of up to 26% for physicians in 2003. Numerous studies confirm that Medicare billing rules are “horribly confusing.” Unfortunately, dependable help is hard to find. A 2004 Government Accountability Office study found that an astonishingly low 4% of billing questions placed to Medicare call centers were answered correctly.

Reacting to the problem:

Q: We probably undercode sometimes and overcode sometimes. Is this common?

A: Coding mistakes are very common. The incidence of miscoding approaches 50% in many estimates. Poor coding practices including undercoding may cost the average practice 10-20% of potential income. Overcoding subjects a practice to the risk of severe penalties. The government has an active interest in pursuing wrongdoers through the Federal False Claims Act since it recovers $13 for every $1 expended for investigation.

Accessing services:

Q: Is an on-site visit necessary?

A: Not necessarily. We frequently work from documents transmitted electronically or via postal mail. However, for some projects, an on-site visit is the most effective approach.

Fee structure:

Q: What fee arrangements are available?

A: Fees vary depending on the scope and depth of the project. We are flexible and customize our billing to provide maximum value. Common options include hourly rates, retainer rates, and project rates.