Course Solutions Uncategorized (Answered) : As a person feels that Medicare or their insurance company did not complete work that warrants a payment. As a regulatory profes

(Answered) : As a person feels that Medicare or their insurance company did not complete work that warrants a payment. As a regulatory profes

As a person feels that Medicare or their insurance company did not complete work that warrants a payment. As a regulatory professional, what key questions should be asked to determine if the allegation warrants investigation or not? Please elaborate.

Expert Answer


As a regulatory professional, there are a few steps that are needed to ensure correct action is taken.

Documentation:

Ask for the documentation and proof of copy from each party
Check the mandatory details are filled in each copy
Verify if there is any hidden or manipulated information in any of the copies.
Check if there is an acknowledgement of the documentation.
Payment details:

If

OR

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