The Most Common Types of Healthcare Fraud and Abuse are:
1.Billing for treatments never performed: Healthcare providers will often bill for services that were never provided by either using a real patient’s healthcare information or through medical identity theft to create or embellish claims.
2. Upcoding: This is a type of healthcare fraud and abuse where they falsely bill for a service that costs more than the service that was actually provided. In addition to healthcare fraud and abuse, this practice impacts patients by falsifying their medical records which can hinder them from obtaining insurance due to a nonexistent previous condition.
3. Performing unnecessary services: This healthcare fraud and abuse often occurs with diagnostic testing in which the doctor knows a test is unneeded but performs it anyway for the sole purpose of billing the insurance agency.
4.Misrepresentation: Typical in the world of plastic surgery, this diabolical healthcare fraud and abuse scam involves changing the name of an uncovered procedure to one covered by the insurance agency.
5. Falsifying diagnoses: By lying about a patient’s diagnosis to justify expensive tests, procedures, or surgeries, the scammer can be paid for unnecessary medical treatments.
6. Unbundling: By unbundling services provided, they can commit healthcare fraud and abuse by billing every aspect of a medical procedure as if it were a separate procedure.
7. Co-pay inflation: This type of healthcare fraud and abuse occurs when a patient is billed for more than his or her actual co-pay.
8. Kickbacks: In addition to accepting kickbacks from pharmaceutical manufacturers, some unscrupulous healthcare providers also accept kickbacks for patient referrals in order to provide unnecessary treatments and collect insurance payments.
If you are the victim of healthcare fraud, contact Attorney Newman at newmanshapiro.com