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4 ways doctors could accidentally commit Medicare fraud

On Behalf of | Jan 28, 2018 | Blog |

As a doctor in Grand Rapids, your main focus is probably patient care. More than likely, you will do whatever it takes to make sure your patients regain their health as soon as possible. Unfortunately, there are other aspects of a medical practice that you have to be aware of as well. For instance, if you mismanage the administrative side of your private practice, you could end up facing a Medicare fraud charge.

There are several mistakes you can make or accidents that can occur that might lead to a Medicare fraud charge. The following are a few ways you or your practice could be unintentionally committing Medicare fraud.

Expired license

It is vital that you and your staff keep your licenses up to date. If you bill for medical procedures and your license is expired, you could easily end up committing fraud. This also includes the gap time between when your previous license expired and the date at which your receive your renewal. In general, if there was no license then the medical treatment did not occur which means the claim your staff submitted to the insurance company is fraudulent.

Lack of supervision

There are certain situations and treatments that require physician supervision. If you do not provide this supervision, you could face some serious charges.

A patient did not receive medication

If you prescribe medications to your patients and bill the insurer for the cost but the patient does not ever receive the medication, you must reimburse the insurance company for the amount it paid you. If you fail to do this, whether on purpose or by accident, it could warrant a Medicare fraud charge.

Billing for services you did not perform

A simple miscommunication between you and your administrative staff could easily lead to fraudulent billing. For example, if your staff thinks that you performed services that you did not actually do and bills for those services, then your practice has technically committed insurance fraud. Even if this was mistake, if you fail to correct it, you could face some serious legal ramifications.

There are many ways you could unintentionally commit Medicare fraud. By being aware of where danger lurks, you can take steps to prevent this from happening. However, if you are facing Medicare fraud charges, keep in mind that you still have rights and options. A strong defense can help you fight back against the charges and possibly avoid a conviction.