Because so many people are involved in a patient's care, the potential for Medicare fraud is enormous. One simple mistake in record-keeping can cause a billing disaster that leads to serious issues for you, whether you are a physician, pharmacist, physical therapist or any other kind of health care professional who represents a link in a chain of caregivers.
Multiple caregivers can lead to multiple errors
Let's say an elderly patient undergoes surgery. The size of this person's health care team is directly related to his or her condition, and the fees for services add u p quickly.
If you have been working in the medical field for even a short period of time, you are no doubt aware of the potential for mistakes. This is due to the amount of record keeping that is required for a patient's average four-day hospital visit. Honest mistakes can be made, but federal authorities are always on the lookout for the possibility of Medicare fraud.
All actions must be logged correctly
Putting patient information into a medical chart, or transferring data from paper to a computer has to be done with the utmost attention to accuracy. The input comes from many sources: nurses, clinical staff, therapists, orderlies, food service workers, janitors, social workers and more, not to mention the doctors themselves. Charges are logged for every service, creating a breeding ground for errors. Mistakes can occur as each of these charges is added to the bill that will eventually be sent to the elderly patient's insurance company.
Finding yourself on the hook
All sorts of errors can be made. The type of treatment or amount of medication a patient has received may not have been documented properly. The dates of treatment, the level of care, even the type of hospital room listed might not have been recorded correctly. There may have been charges for supplies that were not delivered or for services that were not rendered. If inconsistencies come to light and your name comes up, you might find yourself under suspicion of fraudulent activities.
Seek help without delay
Unfortunately, white collar crimes in the health care industry are on the rise and oversight has increased significantly. There are a number of federal laws that govern Medicare fraud and abuse, including the False Claims Act. Obviously you don't want to run afoul of any regulations; your livelihood and your career going forward are at stake. If you are under investigation for fraud, including allegations of overbilling or committing fraudulent medical coding errors, it is important to contact an experienced attorney for help.