Healthcare
is a very big complex industry in the world. Nowadays, healthcare fraud is a
very sensitive issue in all parts of the world.
It involves doctors, health care practitioners and fake medical supply
companies that overcharge and send in false billing invoices to Medicare for
services and the products that have never been provided to the patient. Those
are from other professions who do the same.
Any
type of misrepresentation in health care benefits is regarded as a criminal
activity. Timely active icfeci health care fraud
investigation defense is required to handle such a situation. Which
situations may be regarded as criminal charges?
Here is a look at a few examples.
• Showing false medical bills
• False procedure to get coverage under the
non-covered medical treatments
• Showing false medical insurances
Dishonest
health care providers mainly commit major health care fraud. Health care fraud
is a crime which is not roaming around only to the healthcare provider level
but there are other major contributors like patients, taxpayers, employers,
insurance plan sponsors, and healthcare vendors also. The insurance prices rise
due to healthcare fraud. For every claim insurance companies pay that are
fraudulent we pay higher premiums. It may not be fair but this is exactly what
happens. The premiums are raised so that companies can recuperate money that
has been paid out to those who shouldn't have received it, to begin with. This
has a big negative impact on low-income people.
Health
care fraud has an even bigger effect on our life. Not only do your tax dollars
pay for this but it means that care may be taken away from those who deserve it
and are in desperate need. Imagine children not being able to receive the care
they need because an adult is getting free care simply because they don't want
to work.
This
type of fraud also leads to stricter policies and regulations. Medicine that is
needed may not be available to some people because of a select few cases of
abuse it. Pain medicine is the most widely regulated due to people with
addictions. This, in turn, means that some people may suffer in pain due to not
being able to get the proper medications. Of course, it isn't just limited to
individuals. Doctors and hospitals are involved as well. Some may submit bills
for services they didn't provide. Some doctors and hospitals have even gone as
far as to create ghost patients. Often times this could be as simple as
performing procedures that are not necessary.
The
successful health care fraud investigation will result in the collection
identify and collect all relevant evidence that would indicate the laws, rules
and/or regulations governing health care have been violated, and to identify
storytellers who will be able to testify on matters relevant to the identified
misconduct. The patient file is the crime scene when investigating health care
fraud & abuse.
At
ICFECI, we do healthcare fraud investigation of the cases relating to false
billing, offering health care services without a license, false insurance claims,
false diagnoses, and unauthorized surgery, kickbacks inpatient referrals,
Medicare/Medicaid billing schemes. For more information, contact us @ 214-384-3246.
