If your electronic health record (EHR) template is set up incorrectly and leads you to be billed improperly, it could lead to prison time.

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In recent years, we have heard from many of our clients that their compliance plans received less attention than normal due to the pandemic, staffing issues, and other pressing concerns.

However, compliance enforcement is ongoing and it is essential to prioritize your compliance plan.

A Delaware physician was just convicted of a $5 million fraud scheme.

The physician billed Medicare for injections that he did not perform as billed. He billed for injections that he did not own the required equipment necessary to give the injections to patients.

He has not been sentenced, but faces up to 10 years of prison time for each of the 11 counts of fraud.

If you are using an EHR template, you need to make sure that your practice has it set up correctly. If it is not, it might indicate that you are using equipment that you don’t have or performing services that you cannot actually perform.

While that doesn’t appear to be the case with the Delaware physician, we have seen issues with the template leading to inappropriate automated selections and inappropriate billing that needs to be corrected.

Simple oversight or mistakes can lead to billing errors. It is essential that you have a thorough and effective compliance plan in place to find any issues and vulnerabilities, especially as it relates to your EHR.

We help our clients perform necessary functions to avoid fines and potentially prison time.

We often recommend that healthcare entities:

• Audit their billing and EHR templates,
• Update their policies and procedures,
• Train their employees,
• and ensure that all of their compliance programs are running smoothly.

If you have questions or need help with your compliance program, auditing, or EHR templates, contact Rickard & Associates today.

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