The right to bill Medicare and Medicaid programs, conferred through the award of provider or supplier number, carries a responsibility that may not be abused. The Medical Center is committed to maintaining the accuracy of every claim it processes and submits. Many people, throughout the Medical Center, have responsibility for entering charges and codes for clinical services. Each of these individuals is expected to monitor compliance with applicable billing rules. Any false, inaccurate, or questionable claims should be reported immediately to a supervisor or to the Compliance Office.
False billing is a serious offense.
Medicare and Medicaid rules prohibit knowingly and willfully making or causing to be made any false statement or representation of a material fact in an application for benefits or payment. It is also unlawful to conceal or fail to disclose the occurrence of an event affecting the right to payment with the intent to secure payment that is not due. Billing excessive charges Medical Center employees and agents who prepare or submit claims should be alert for these and other errors. It is important to remember that outside consultants only advise the Medical Center. The final decision on billing questions rests with the Medical Center.