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Greensense Billing > Blog > Blogs > The Most Common Medical Billing Scams
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The Most Common Medical Billing Scams

As per the medical experts, they lose approximately 30 cents of every dollar they earn due to medical billing  scams, that they have to bear in the Medical Billing industry.

With a bucket load of loopholes and technicalities that are vulnerable to fraudulent practices, and the regular person’s incapability to juggle their way through a load of paperwork, it’s unsurprising that people and the government fall for the heaps of medical billing fraud each year.

Let us look at some of the most common kinds of medical billing frauds that are ongoing and the ways to avoid them:

Durable Medical Equipment (DME) fraud

Medical billing fraud covers medical equipment scams consisting of wheelchairs, crutches, hospital beds, oxygen equipment, and diabetic testing supplies. These equipment are expensive and is specifically designed to help immobilized and geriatrics patients.  Medical billing provides a supportive platform for those who have limited income to help provide the best possible care.

Upcoding

Upcoding is a form of overbilling. This is when a respective patient or insurance carrier is charged an amount higher than what it is supposed to be for a medical service.

Duplicate Charges

Duplicate charges are somewhat similar to what upcoding is, as it is also a form of overbilling. In this instance, a health care procedure is charged twice. Ever wondered how overlooking something in a medical bill can go under the radar, or have you ever asked for an explanation of benefits? One can see how this can be an easy way of squeezing more money out of a patient and/or insurance carrier .

Incorrect Quantities

A medical biller who is possibly unethical could charge a patient more than what they owe by misleadingly increasing the overall quantity of medications or other medical items received by the patient.

Phantom Charges

Phantom charges are another form of medical billing fraud.  It occurs when a respective patient or insurance carrier is charged for a service that the patient has never received.

Unbundling

Unbundling occurs due to the division of charges that should have been totaled beneath the same procedure code. This kind of error made on purpose can be very tricky to catch unless one is a qualified medical billing coder.

GreenSense Billing

With the vastly experienced and knowledgeable team at GreenSense Billing, we know every detail aspect of the medical billing industry. Keeping ourselves ready for the changes and the challenges in the medical billing world of the future, GreenSense Billing strives to be there for healthcare providers and their patients with our hardworking, honest, and our ethical billing experts on their side. Once you are on board with us, you’ll never have to worry about any fraud or scam issues with your medical billing services.

 

 


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