Medicare billing is different from "regular" insurance billing and coding. It is easy to make errors/mistakes in the level of service provided and the result can be hundreds if not thousands in overpayments to a vendor/doc/hospital. Most large billers (hospitals and large medical practices) have auditing departments that check and re-check for accuracy. But errors are still made. The normal course is that Medicare notifies the office of a suspected error and you are asked to provide proof of the level billed for or, in the alternative, repay the amount in dispute. You have sixty or ninety days to respond. You do not DARE ignore these seemingly harmless requests for review. If you ignore them, you'll risk triggering a full blown audit. They can audit and go back ten to fifteen years if they suspect intentional fraud. Three years if they just suspect sloppy billing and coding.

I know billers who drive new SL's courtesy of their grateful employers and who's bonus checks every quarter pay for luxury homes and european vacations. And those bonus checks are on top of a base salary of $150/200k per year. There are perhaps 50 in the country at that level and they routinely milk the system for an extra seven or eight million per year. Then they usually split the overpayments with the doc(s) and keep a healthy portion for themselves.

We were approached when I was in practice by a couple of these "super billing groups" that promised us much. I avoided them. Figured they'd get caught eventually. Pity is, most of them are never caught.