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Investigation plan equals your road map

Jay P. Anstine ( is Compliance Program Director, Western Division, Banner Health, Greeley, CO.

Assume you work for Doofenshmirtz PC, a physician practice specializing in orthopedics. You just got off the phone with the billing manager, who is alleging that due to a recent Medicare billing rule change, the practice may have incorrectly billed for a type of orthopedic service. After ending the call, what’s your next move? If it were me, I’d create an investigation plan before I did anything else.

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