How to avoid Health Care Fraud through Investigation?

Today, health care fraud is the headache of an entire world. It's no secret that healthcare fraud accounts for an estimated 100 billion dollars a year in the United States alone, and it's increasingly a reason that health care costs continue to rise. Unnecessary and fraudulent treatments are being submitted to payer organizations by organized crime and con artists have become big business in the world today. Increasingly, health insurance organizations are looking for new ways to detect, investigate and prosecute anyone submitting fraudulent health care claims. 

Healthcare fraud is a problem in the world, yet gets very little attention in the news media. It is a problem that needs to be solved in order to reduce the cost of health care for all of us. Independent review organizations are playing an increasingly important role in reducing health care fraud by helping fraud special investigative units close fraud investigations and provide important insight about which cases should be paid and which shouldn't.

To serve mankind, health care is a very sensitive issue in all parts of the world. Not only the third world underdeveloped countries, the countries like United States of America and European Union has always been seen in crisis over health care across the past decades, although the advancement in science, research and technology has brought wonders but still the healthcare frauds and health care crimes are increasing in huge numbers. The entire world is facing this problem.

Actually, we don't really need a reform in the healthcare industry but we need an approach to find out the places where a highly developed country can also lack in services of health care. It needs to pick out the health care fraud right from its root cause can curb the problem in a huge and decided manner.

Health care fraud steals the very essence of human life. The list of examples can create shocking news and generates a sense of hopelessness. So ICFECI health care fraud investigation is needed to overcome the issues. 

10 Things Which Indicate a Health Care Fraud:

•    Medical incidents or medical practices that are not consistent with the standard of care (substandard provision of health care).

•    Unnecessary cost to a healthcare program caused either directly or indirectly.

•    Payment in improper way or payment for services those fail to meet professional standards.

•    Medically unnecessary services

•    Substandard quality of treatment (e.g., in nursing homes)

•    Elaborated Schemes and cover-up strategies and failure to meet insurance coverage requirements.

•    The false statement of services rendered or goods provided.

•    Obtaining false insurance information

•    Unreasonable rates and misrepresentation of value and services regarding health care.

•    Consumer health care fraud. One example is forging family names to provide coverage to friends with the intention of dividing up the reimbursement.

At ICFECI, we, the healthcare fraud examiner, have knowledge and experience in this field and helps in solving the case of the accused. We investigate cases relating to false billing, false insurance claims, false diagnoses, forcing patients to undergo tests or surgery solely for pecuniary gains, and Medicare billing schemes. Get in touch with health care fraud investigation.