Incorrect use of Modifiers

Incorrect balance billing

Duplicate claims

Misuse of provider numbers


Patient Confidentiality

Routine Waiver of Co-payments

Discounts / Professional courtesy

Assumption Coding

Coding without proper documentation

  • Check, Protect the privacy and security of health information
  • Define standards for electronic submission
  • Improve efficiency and effectiveness of health care system
  • Security
  • Privacy
  • Transition & Code sets