Common Types of Healthcare Fraud
If accused of healthcare fraud, consulting a Florida defense lawyer in Fort Lauderdale may be helpful in evaluating the accusations so a defense case can be organized.
Some common healthcare fraud cases include:
Billing for services not rendered – A claim is submitted for medical services that were either not rendered at all, were not rendered as described, or rendered but already billed and paid.
Upcoding – The medical care provider submits a bill coded for a higher-cost service, but a lower-cost service is actually rendered. For example, a doctor’s office may see a patient for a follow-up visit but bill it as an initial consultation at a higher cost.
Submitting duplicate claims- Billing an item or service twice on separate claims is another type of healthcare fraud. The claims will differ slightly, usually by date of service or quantity of item, so the claims will not be identical even though they are for the same instance of medical care.
Unbundling – This involves submitting multiple claims that fragment the billing of tests or procedures that are required to be billed together. This allows health care providers to maximize the charges for these tests that are typically ordered in “panels” such as a lipid panel.
Excessive services – Ordering items or providing care in excess of the patients’ needs. For example, requiring daily office visits for a patient who would receive the same benefit from weekly or monthly visits is another type of healthcare fraud.
Medically unnecessary services – Similarly ordering items or providing services that are unnecessary for the patient’s care. For example, ordering tests that have no impact on diagnosing a patient’s condition or evaluating a health concern.
Kickbacks – When a health care provider receives something of value for referring, promoting, or requiring a specific product or service from another company, it may lead to a healthcare fraud case.
If accused of fraud, doctors, healthcare facilities or other parties may consult a Florida defense lawyer in Fort Lauderdale to discuss legal options.
Erroneous or Embellished Healthcare Fraud Cases May Harm Your Practice
Doctors are most often faced with charges of healthcare fraud, especially with Medicare or Medicaid cases. If an investigation is not properly conducted there may be errors in the case that could result in higher penalties and convictions.
If you are a medical provider or a health care recipient facing accusations that your recent health care claims activity is defrauding a public or private health care program, you may need legal help. A Florida defense lawyer in Fort Lauderdale can offer legal consultation, help build a case and offer representation in legal actions.
Whether you’re a doctor, health care facility, or medical service provider, if your claims are being challenged, you may schedule a consultation with a Florida defense lawyer in Fort Lauderdale to go over your healthcare fraud case and your rights if accused of any of the various types of healthcare fraud.