Often referred to as simply an EMG, this electrodiagnostic test has two components: a nerve conduction study (referred to as NCV or NCS) and a needle EMG. The quality of these exams depend on the training and integrity of the provider. As such, poor quality and fraudulent EMGs are common. Read on to learn why EMGs are vulnerable to fraud and abuse.
Nerve Conduction Study
(tests and records nerve activity)
Needle EMG
(tests and records muscle activity)
Take a dive with an interactive presentation and learn how deep EMG fraud goes and the steps you can take to get ahead.
Inexpensive equipment allows easy entry into the field.
No training requirements-any licensed physician can lawfully perform studies.
Lack of quality control reviews by carriers.
The nature of the test-the only objective evidence occurs in the room with the patient.
What’s The Impact?
Fraudulent providers cost the industry millions each year by driving up claims costs and making carriers pay for exams that are fabricated or haven’t been performed at all.
In a presentation at an AANEM annual meeting, our Chief Clinical Officer Dr. Robinton, together with a former Medical Director of a top 10 insurance company, stated that more than 60% of reports submitted by uncredentialed providers were deemed to be of unacceptable quality.
Poor quality and fraudulent providers cause unnecessary treatments for patients, such as pain injections and surgery.
More than 60% of reports submitted by uncredentialed providers were deemed to be of unacceptable quality.
What’s The Solution?
Educate
Learn how EMGs may be affecting your organization
Detect
Utilize A4D’s services to determine the medical usefulness of an EMG
Manage
Look for patterns of fraud and prepare to take legal action