How can you avoid Medicare fraud charges?

On Behalf of | Nov 21, 2019 | Health Insurance & Medicare Fraud |

Both Tennessee and federal officials are serious about cutting down on health insurance and Medicare fraud. This is one of the reasons why they urge consumers to be on the lookout for health care scams. There are certain steps that you should take as a medical professional or biller to make sure that you don’t end up on the wrong side of the law.

First, you should do your due diligence to confirm the identity of your patients. You should ask them for photo identification to match their names with their faces. It could land you in legal hot water if you billed an insurance plan because you saw the wrong patient.

It’s important that you also only bill for necessary services and also ones that a patient actually received. It’s illegal for a medical professional to bill for extra services beyond what a patient agreed to or is medically necessary for them to receive. Many health care professionals have been arrested for billing for unnecessary services to make a quick buck.

Medical care professionals have also been charged with Medicare and insurance fraud after offering gifts or money in exchange for a patient scheduling certain procedures. It’s not only unethical for you to offer incentives for someone to schedule a service, but it’s deceptive.

Patients are taught by the U.S. Centers for Medicare & Medicaid Services to closely review their Medicare Summary Notice when they receive it to see what prescriptions or services that it lists them as having received. If anything is there that they don’t remember, then they’re instructed to call in and report such instances.

There are instances in which errors occur. The wrong billing code may be used and a patient may end up being billed for a service that they didn’t receive. If the patient contacts you and you fix the isolated error right away, then Medicare may write off the concern as an honest mistake. Insurers may not view habitual errors the same way though.

Your medical license and freedom are on the line once you’re charged with a criminal offense. This is why you must consult with a health insurance & Medicare fraud attorney right away if you’re charged with a crime. Your Murfreesboro lawyer can advise you of potential defense strategies that you can pursue in your Tennessee case.