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- Jan 26, 2004
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I worked as an insurance adjuster for years. I'm quite aware of how it works.
The audits showed much more than accidental or objectionable miscoding.
Blatant fraud.
Same code numerous times. Codes that aren't even related to the procedures received.
Corruption.
Did you or your employer report them for fraud? If the bill is paid by Medicaid they need a report to investigate. To save health care money the agency is on a search for fraud now and have made several big arrests lately, fraud in millions of $.