How a Fraudulent Billing Case Could Be Impacted by an Accountant
The individual or entity responsible for a medical provider’s financial accounts could provide testimony regarding their practices. Expert witnesses are often called by Fort Lauderdale attorneys for a variety of reasons.
This might harm a case if he or she reveals suspicious billing activity based on fraudulence by testifying about:
- instructions from management;
- a charge for services never provided; or
- applying incorrect costs to a bill.
An accountant may even be able to show that an employee of a hospital, physician’s clinic or other medical setting was falsifying information in order to misappropriate funds.
The accountant could show that there are discrepancies in:
- billing codes;
- patient identification; or
- medications prescribed.
On the other hand, a healthcare fraud case can be helped by an accountant’s testimony. It may be that billing was done correctly or any mistakes made weren’t intentional. There may have been a misunderstanding regarding billing codes or what appeared to be suspicious billing activity was really nothing out of the ordinary. Although mistakes don’t necessary negate responsibility, it could lead to reduced charges.
Types of Healthcare Fraud Involving Accounting Practices
The keeping of books can sometimes lead to double dipping or charges for services that are without warrant. Services never rendered or billing for more expensive procedures than were provided are examples of fraudulent billing. In some cases patients may actually undergo treatment or care that is unnecessary just for the sake of financial gain.
Another example of fraudulent billing would be breaking a procedure down into steps so that it appears several procedures were performed or charging for something that had already been paid for, either by the patient or health insurance.
Many healthcare fraud cases stem from mistakenly entering incorrect information or other unintentional incorrect billing practices. At The Law Offices of Robert David Malove, we understand the impact expert and non-expert witnesses can have on a case and how they may help or hurt. For assistance determining the types of evidence that will be necessary to defend against charges of healthcare fraud, contact us today.