”How To Tackle Healthcare Billing Fraud” is a collaborative post. Please see the disclosure page for more information. Disclaimer – always verify medical information with your doctor or a professional.
Everyone knows that healthcare is an expensive business, but not everyone knows why this is the case. There are high charges because of all the advanced equipment and expertise of the nurses and doctors that work in hospitals. Costs also include the administrative tasks, mechanical costs for the building, utilities, insurance, and so much more. There also is sometimes something else at play, too: costs that should not have been added have been placed on the bill and sent to the insurance company.
These could be complete accidents or could be healthcare billing fraud.
How does this happen?
This doesn’t always happen intentionally. In many cases, incorrect billing is down to a genuine error. But there are instances where it’s outright healthcare billing fraud — this is when a doctor bills for services that the patient didn’t receive. Part of the problem with this is that it’s hard to detect. Ultimately, only the doctor and patient know what services were received, but the patient doesn’t always see the bill or even the itemization of the bill.
Get an itemized copy of your bill
While there are numerous ways to help improve the billing process to reduce healthcare billing fraud and unintentional errors, the best method is to involve the patient in the billing process. This is a simple method, one that can help flag up any contested treatments and services at the earliest stage possible. As a patient, you can assert yourself and ask for an itemized copy of your bill. Other methods include looking to improve internal controls so that the billing process is improved.
On the front line of improving the billing errors will be the accountant manager, who can help to organize internal policies and also help to engage patients with the billing process.