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Re: Fraud reporting

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Jon;

Start with your local Medicare Intermediary. Usually, before a case gets

turned over to the OIG, the Medicare Intermediary does a preliminary audit of

their own. In order for any case to be turned over, the Medicare

Intermediary has to prove that it's financial scope exceeds $10,000. So

start with your provider representative at your local Medicare Intermediary

and they will take it from there.

Jim Hall, CPA <///><

General Manager

Rehab Management Services, LLC

Cedar Rapids, IA

Formerly employed at a Medicare Intermediary's office

Visit our Web Page at:

http://memebers.aol.com/jhall49629

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Jon:

It's always good to involve your Congressman in problems that affect his

district.

Inquiries to HCFA from Congressional offices are handled with much more

dispatch!

Even if you have managed " to get through " the 800 number, it is smart to let

your Congressman know what is happening.

Good luck!

Lucy Buckley PT

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Jon --

If your local competitor is using Revenue Code 420 (Physical Therapy),

they're holding their services out as physical therapy.

If they require a PT referral from the doc... same, same.

If they're using a HCFA 1500 bill, and charging as PT... same same.

If they're using CPT Codes for a procedure which requires the physician

or therapist...

If they're in violation, and you SUE them as a " qui tam " (whistlebolwer)

suit, and the Feds join in the suit, ... YOU get ~15-30% of what the

Feds get...

Just a mid-day quickie!

Dick Hillyer, PT

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