Medical Billing Fraud costs Insurances and Patients Money
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Medical billing fraud is committed when a medical facility or office intentionally bills procedures that may not have happened or misrepresents procedures that did happen in order to increase the amount processed, thereby deceiving insurances and patients into paying more for services. Medical billing fraud costs insurances, providers and patients millions of dollars each year
How to Report Medical Billing Fraud
1. Read all health care bills carefully, including insurance explanation of benefits statements to properly determine if all the procedures happened that were billed by the medical provider. If you do find something that looks suspicious, contact the medical billing department to make certain you are reading it correctly and verify what the service or procedure entails.
2. Call your insurance provider to let them help you decipher any discrepancies in your billing from the medical provider. Insurance offices are equipped to handle medical billing fraud and will review the procedures and services carefully to make sure they were properly processed.
3. Ask for copies of your medical records from the medical provider, along with complete billing statements. Medical records and billing statements can help you determine what procedures and services were provided and at what cost.
4. Contact your state's Department of Insurance office either online or with a letter and documentation of any medical billing discrepancies you have found. Department of Insurance offices also have a toll-free hotline available to report insurance fraud, however eventually you will need to furnish them with copies of any paperwork you have that pertains to the services in question. The Department of Insurance website also has a fraud reporting form available that can be printed out and mailed along with your medical documentation of the service in question.
5. Contact the National Insurance Crime Bureau either online or with a letter to report any fraudulent medical services or procedures. The National Insurance Crime Bureau is an organization that was started to prosecute any fraudulent medical services by any medical facility or office.
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