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Doctor UPIN data often wrong: OIG
Nearly one-third of the addresses for physician and practices listed in Medicare’s Unique Physician/Practitioner Identification Number (UPIN) Registry are wrong, according to a study by the Office of the Inspector General (OIG).
"Even the Medicare carriers did not have correct addresses for all of these providers," the OIG’s report noted, opening up the possibility that many of the wrong addresses are being used by scam artists to bilk Medicare.
To get a UPIN, a doctor or group practice must submit a Medicare enrollment application, including relevant addresses, to the appropriate carrier. Once the registry assigns a UPIN, the carrier is responsible for maintaining physician enrollment data and promptly notifying the registry of address and other changes.
In 1999, the OIG reported that 39% of UPINs were listed as active in the registry, even though those practice settings had no Medicare claims activity for 12 consecutive months, which is grounds for deactivation of the UPIN.
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