What Is Healthcare Billing Fraud and How Can It Be Stopped?
What Is Healthcare Billing Fraud and How Can It Be Stopped?Answer: The National Health Care Anti-Fraud Association estimates that 3% of the more than $2 trillion spent on health care in 2007 is lost to fraudulent activity. Other organizations estimate fraud to account for up to 10% of all costs. Medicare fraud is legend, and most of the time it goes undetected, costing taxpayers billions of dollars each year. Healthcare fraud takes place in a number of ways, on the part of many providers in health care, who may: • Bill for services they did not provide. • “Upcode,” meaning they provided a service, but billed for a higher level of that same service. For example, you may have symptoms of a cold. But your doctor may bill for pneumonia, even though all you really have is a cold. • Provide unnecessary services. You may get an EKG in the doctor’s office, even though you don’t need one. These services are always extras
