Ingrid Martin article on increasing use of 'Big Data' to prosecute medical billing fraud cases published in industry journal
Ingrid S. Martin's article on the government's increasing use of data analysis to investigate and prosecute medical billing fraud cases was published in Healthcare Business Today.
"In analyzing billing data," Ms. Martin wrote, "government investigators are looking for providers with suspect billing patterns, including high utilization of expensive billing codes, being a top biller for any particular code, or billing in a manner that is different from other providers of the same type."
Ms. Martin, a partner at Todd & Weld LLP, offered guidance on the steps healthcare providers should take to implement an effective compliance program, including detecting and assessing outlier billing and diagnosis codes, and effectively documenting medical services and associated billing codes.
Ms. Martin concentrates her practice on representing healthcare providers in a wide range of matters, including defending against false claim submissions and exclusion from Medicare, Medicaid, and other federal healthcare programs.