Medical Billing Services – Medical Billing Frauds are Costing Billions
- September 22, 2021
- Business and Management
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According to the National Health Care Anti-Fraud Association, healthcare fraud costs around $68 billion annually to the American people, about three percent of their $2.26 trillion in healthcare spending.
Every year, hundreds of providers are charged for fraudulent and unethical practices in different states, and there is no end to it.
Actually, fraud in healthcare is prevalent just like any other industry. There are countless ways where fraudsters can trick the system in their favor to maximize their profits.
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Common Medical Billing Frauds
There are various types of frauds on rife in the healthcare industry today and occur in many different settings. Some of the common medical billing frauds include;
Billing for Services Never Rendered
Healthcare providers are only paid for medical treatments and procedures that are actually performed. Both Medicaid and Medicare can provide reimbursement for the procedures, tests, and treatments they are authorized to perform.
Duplicate billing, sometimes also referred to as double billing, occurs when a provider attempts to bill more than once for the same service. It typically involves sending a bill to Medicare or Medicaid and either the patient or a private insurance company for the same treatment.
Billing for Fictitious Services
It is another common medical billing that happens when a provider bills for the procedures and treatments that were not actually provided at all.
Billing for Non-Covered Services/Items
There are several services and items that are not reimbursable by both government and private insurance providers. Providers may label non-covered services and items as covered in order to obtain reimbursement they are not entitled to.