通过工作时长检测医疗保险报销中的潜在超额收费:评论

Detecting Potential Overbilling in Medicare Reimbursement via Hours Worked: Comment

American Economic Review · 2020
被引 6
人大 A+FT50ABS 4*

中文导读

评论了Fang和Gong(2017)检测医生超额收费的方法,指出其使用汇总数据可能夸大服务数量,并展示审计人员如何利用详细理赔数据更精准地定位不当超额收费。

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.

医疗保险超额计费审计工时数据索赔级数据