Detecting Potential Overbilling in Medicare Reimbursement via Hours Worked: Comment

IF 10.5 1区经济学 Q1 ECONOMICS

American Economic Review Pub Date : 2020-12-01 DOI:10.1257/aer.20180812

Brett Matsumoto

引用次数: 3

Abstract

Fang and Gong (2017) develop a procedure to detect potential over-billing of Medicare by physicians. In their empirical analysis, they use aggregated claims data that can overstate the number of services performed due to features of Medicare billing. In this comment, I show how auditors can use detailed claims-level data to better target improper overbilling. (JEL H51, I13, I18, J22, J44)

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通过工作时间检测医疗保险报销中的潜在超支:评论

Fang和Gong(2017)开发了一种程序来检测医生对医疗保险的潜在超额收费。在他们的实证分析中，他们使用了汇总的索赔数据，这些数据可能夸大了由于医疗保险计费的特点而执行的服务数量。在这篇评论中，我将展示审计人员如何使用详细的索赔级别数据来更好地针对不当的超额收费。(j51, i13, i18, j22, j44)

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Economic Review ECONOMICS-

CiteScore

18.60

自引率

2.80%

发文量

122

期刊介绍： The American Economic Review (AER) stands as a prestigious general-interest economics journal. Founded in 1911, it holds the distinction of being one of the nation's oldest and most esteemed scholarly journals in economics. With a commitment to academic excellence, the AER releases 12 issues annually, featuring articles that span a wide spectrum of economic topics.