27 May Physician Billing: The Costs of Overbilling
Overbilling costs the U.S. hundreds of millions and perhaps, according to some sources, over 1 trillion dollars a year. Overbilling, which sometimes occurs by accident but is most often a fraudulent activity, is monitored by various entities, including commercial insurance providers and federal and state agencies. When it occurs and is discovered, fines can be well over a million dollars, and the loss of public trust in the medical practice or healthcare institution that participated in the activity can be irreparable.
A medical practice, doctor, or hospital depends upon the public trust, and when they lose that, they can also lose their ability to generate income. This is especially true in the case of a doctor or practice. Even if the charges are proven to be false or are dismissed, the damage done can be insurmountable. Therefore, it’s best to make sure that all medical insurance claims submitted on your behalf are accurate documents that are impeccable in terms of the information they provide.
The cost of defending yourself against federal or state charges related to fraud can be astronomical. Doctors, medical practices, or hospitals can easily spend millions on lawyers. If the federal government has built a case against a healthcare provider, they will come to court armed with excessive amounts of evidence, expert witnesses, and a long list of charges. They will also have a very deep legal team. That means it will cost a lot of money to try to defend oneself against federal fraud charges related to overbilling.
If one is accused and convicted of overbilling, which is fraud, the costs can be millions if not hundreds of millions of dollars. Usually the medical practice will have to repay the amount the government says they have taken, plus interest and penalties. Often the government or insurance company will forego a trial if they can strike a deal where the cash they are charged with taking and other appropriate funds are repaid. That being the situation the lawsuit is usually dropped and those charged admit no wrongdoing.
If convicted of medical insurance fraud, one can be sentenced to years in federal or state prison. Sentences for those who abuse the public trust and bilk the government and commercial insurance companies of millions of dollars are uncompromisingly tough.
Guarding Against Fraud
At the medical billing and coding company, Medical Practice Management Resources, Inc., professionals are dedicated to being vigilant in guarding against fraud. Along with making surer that medical practices are reimbursed in an appropriate and timely manner for the services they have offered, we are also devoted to making sure that the system in which we work maintains its integrity. If your medical practice needs a medical billing and coding companies that upholds the highest standards in the profession, contact our medical billing specialists today.