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What Is The Difference Between Healthcare Fraud And Healthcare Abuse?

A healthcare lawyer may be required if there is suspected healthcare abuse or fraud. While you might think fraud and abuse of the healthcare system isn’t possible, you’re very much mistaken. Fraud is one of the worst problems within the medical profession today, and it’s not just patients who are responsible, sometimes, doctors and healthcare professionals are at fault. However, do you know the difference between healthcare fraud and abuse? If not, it’s time you understood what they mean and how they could impact your career. Click here!

Fraud and Abuse – What’s The Difference?

Healthcare abuse is essentially charging more for services rendered or add unnecessary costs onto those services. Healthcare fraud is knowingly and intentionally billing for services which were never given. In the end, it comes down to the intent of the action of the person committing the offense. For example, a patient may say they’ve received additional treatment from a physiotherapist, or say they will in the future, and claim for a cost higher than what the actual treatment will be, pocketing the additional money left over. That’s fraud. Another example is when a doctor knowingly puts in a claim for treatment that was never given and them receiving the total cost personally. A healthcare fraud attorney might be required if you’re suspected of this crime.

Abuse and Fraud Are Closely Link

There’s the old argument that abuse of the healthcare system is not a crime, but that’s not quite the case. Abuse of the healthcare system is a crime, and while it might not appear as bad as healthcare fraud, it’s pretty bad. Fraud of the healthcare system is an abuse of the healthcare system also, but also, if committed by a doctor, an abuse of the patient. The truth is that fraud and abuse are closely linked with one another and if you are suspected of these crimes, consult a healthcare lawyer. For more information visit:
https://www.wikihow.com/Select-a-Medical-Malpractice-Lawyer

Prevention Is Crucial

Fraud and abuse of the healthcare system is often tough to spot, whether you’re a patient or a doctor. Sometimes, patients don’t suspect of their doctors of fraud, and it’s easy to see why. You don’t expect a medical doctor to commit an act of fraud; however, that doesn’t mean to say it can’t happen. It’s the same with patients; they too can commit fraud or an abuse of the healthcare system. Preventing fraud is a necessity. Is the procedure necessary? Has the patient been verified as eligible for the treatment? Always double check the patient and their medical history. You should always think about whether the diagnosis is correct so that you can help prevent fraud. If you’ve been suspected of fraud, contact a healthcare fraud attorney.

Get Help When You Need It

Healthcare fraud and abuse are serious problems and they can be committed by anyone, including a member of the medical profession. Whenever you’re suspected of fraud, you must seek help from a trained healthcare fraud lawyer or attorney. These are the people to help you prove your innocence and should be used. Find a good healthcare lawyer if you need help with healthcare abuse or fraud.…

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What Are The Potential Penalties For Health Care Fraud And Abuse

Asking the doctor to issue two invoices to get reimbursement of the total amount of the consultation with the health plan or doctors who direct the brand of a particular product to earn commission from a manufacturer are common practices, but constitute a crime. However, these crimes, done by patients, suppliers of drug-medical-hospital materials or even by doctors themselves, only cause harm to consumers, often times leading to the need to hire a health care lawyer. The frauds committed against the health plans, which often only benefit the practitioner itself, further make plans cost more to the beneficiaries.

Omission of diseases

Fraud can start already in the completion of the questionnaire of the plan, when the consumer decides to omit a pre-existing disease. Fraud occurs when people know about the disease, but it omits. People act against the law and believe nothing will really happen to them. This might seem fine, but those who do it often need the help of a Health care fraud attorney to get rid of the issue.

Using someone else’s health plan

When the beneficiary allows another person to use his social security number or any other sort of documentation and see a doctor. Allowing someone to take advantage of the plan is fraud. For this reason, many doctors’ offices and laboratories ask for the original document and photo before carrying out a procedure. In this case, there are two crimes: presentation of false documents and false identity. Click here.

Two receipts for a single appointment

It is common in a doctor’s office to request two receipts, with different dates (separated by more than 60 days, for example), but related to a single consultation or procedure performed. The behavior is very common in the modality “free choice” of professionals, marketed by some plans. In this category, the plan has a limit value per consultation, but in general, it is below the price that some doctors charge when attending private patients. There is an agreement between the operator and the tax authorities, this difference between notes can be traced , leading the need to hire a Health care fraud attorney.

Families create companies to have a business plan

There are increasing cases of families that open up front companies only to achieve adherence to a corporate plan. The modality is cheaper when compared to the collective or individual plans. However, besides being a prohibited maneuver, it is important to warn that the plan could be more expensive in the long term. This is because, if one of the beneficiaries or their dependents face any serious health problem, the monthly fee may increase dramatically, since the group has a small number of people.

Change to higher value of reimbursement receipt

 In this case, the professional asks if the patient wants a receipt with a value higher than the value of the consultation, in this way the beneficiary receives a refund amount greater than the amount paid. The practice, totally illicit, affects daily health plans, which end up having higher expenses and, consequently, the costs with tuition increases. The doctor who is convenient with this practice may have to pay more taxes because there will be divergence in the income tax return. Both patient and clinic might need to get a Health care fraud attorney to sort the situation out. To find out more, check out https://federal-lawyer.com/healthcare-defense/

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