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 into 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, countries like United
States of America and the 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.
