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Education-awareness letters to the Medicaid provider community
Patel, Janki South Carolina Certified Public Manager Program
Patel, Janki
South Carolina Certified Public Manager Program
Abstract
SCDHHS currently does not have a process in place for making providers aware of their billing anomalies without conducting a review/audit of them. SCDHHS needs an effective process for sending education letters to members of the South Carolina Medicaid Provider community with atypical billing patterns and for tracking the impact of the letters on the providers’ future billing
behavior. The goal is to have data mining carry the weight of this project by utilizing minimal resources and time. implementing this proposed process of sending education letters to address the providers’ billing behavior, will allow the Division of Program Integrity to monitor the behavior without conducting a comprehensive review and investigation. This, in turn, will benefit the department as it will be counted as a cost avoidance measure using minimal manpower and resources, which will result in better outcomes and save on provider reimbursements.
Issue Date
2022-03-01
Keywords
Medicaid--South Carolina, South Carolina Department of Health and Human Services
Type
Text
Rights
Copyright status determined to be in the public domain on April 27, 2020 by United States Supreme Court ruling (Georgia et al., Petitioners v. Public.Resource.Org, Inc. : 590 U.S.__(2020))
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