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Health care fraud is…

On Behalf of | Aug 7, 2020 | Uncategorized

Health care companies and individual providers work hard to provide both preventative and curative treatments, as well as medical devices and pharmaceuticals to Michigan residents who need them. The services they offer often come with a hefty price tag, but they have every right to be paid for what they do. Unfortunately, some end up being accused of health care fraud while seeking fair compensation for their work.

Health care fraud comes in numerous forms. However, it is questionable billing practices that often result in health care professionals being accused of fraud. Some examples of billing issues that can trigger an investigation include:

  • Padding claims: Billing for serves not rendered
  • Unbundling: Charging for individual steps of a procedure
  • Over-billing: Waiving deductibles or copays in order to bill more to insurance
  • Upcoding: Charging for more expensive procedures than those actually provided

Outside of billing problems, other common types of health care fraud include accepting bribes for patient referrals, falsifying records, and performing unnecessary services. At the end of the day, health care providers should only prescribe medical equipment and medications if their patients can truly benefit from using them. They also should not put their patients through any more than is absolutely necessary.

The line between acceptable health care practices and health care fraud is a fine one. The vast majority of the professionals that work in the health care industry do practice above board, but because of a few bad eggs, every move they make can come under scrutiny and accusations of fraud may follow. Health care professionals in Michigan who find themselves facing fraud charges do not have to fight the charges on their own. With the assistance of legal counsel, steps can be taken to address this type of situation and to fight for the best possible outcome.