Charges of medical billing fraud can lead to significant fines and possible imprisonment. In this type of case a variety of witnesses may be called upon who could be helpful in defending against these charges. However, it’s also possible that a witness would harm a defendant’s case. One type of witness that may be called upon is a medical billing professional who can testify about the billing practices of the medical professional or clinic. Common types of billing fraud about which the expert witness may testify include:
  • upcoding;      
  • unbundling services;
  • double billing; and
  • submitting false claims for services not rendered.

Impact of a Medical Billing Professional on a Fraud Case

A medical billing professional could be utilized as an expert witness in order to provide testimony regarding a number of issues stemming from innocent mistakes to outright deception.

For instance, this type of witness may provide testimony that indicates mistakes in billing weren’t the result of intent, but rather neglect or human error. Although this doesn’t always mean the individual or entity isn’t responsible, it could significantly impact the types of charges the defendant faces and potential penalties if found guilty.

Of course, a case could be harmed by the testimony of a medical billing professional as well. The witness could testify that incorrect billing codes appear to have been used in order to receive more payment. Or an incorrect diagnosis was given in order to justify treatment/procedures that weren’t necessary or perhaps never even provided.

In some cases a medical facility wasn’t attempting to defraud patients. But instead it was an individual employee who was engaged in deceptive practices in order to gain financially or perhaps even as a means of retaliation. A medical billing professional may be able to substantiate this claim.

Seeking Legal Help When Facing Healthcare Fraud Charges

With the possibility of hefty fines and even imprisonment, if a medical professional or entity is facing charges of medical billing fraud, it would be a good idea to contact an attorney. The Law Offices of Robert David Malove provide legal defense to those accused of misrepresentation or other crimes stemming from medical billing practices. We can help in ensuring one’s rights are protected throughout the process. Call us today: 888-744-8225.