It is important for you to act quickly if you are accused of medical billing fraud. This allegation can hurt your practice. People may not want to go to your practice if they find out that you have been accused of medical fraud. Not only can it hurt your reputation, but you may also have to spend time in jail or pay a fine. One of the best things that you can do if you have been accused of fraud is to hire an attorney.
Examples of Billing Fraud
Billing fraud is a broad term that can refer to a number of things. The following can be classified as billing fraud.
- Billing for referral fees and kickbacks-
- Billing for medical services that were unnecessary
- Billing for services that were not performed
- Billing for excluded or unlicensed services
- Billing someone twice for the same service
- Using the wrong code for a medical service
- Up coding-Billing someone for an amount that is higher than what is allowed
Frequently Asked Questions About Medical Billing Fraud
What Should I Do if My Practice Has Engaged in Medical Billing Fraud?
If you suspect that your practice has been engaged in fraud, then you will need to audit all of the billing practices. You will also need to make changes to your procedures.
What Do I Need to Do if I Have Been Contacted by the Authorities?
You will need to talk to an attorney if you have been contacted by the federal and state authorities. The authorities may request to have an interview with you. However, you do not want to talk to them without speaking to an attorney first. Anything that you say can be used against you.
What Type of Penalties Can You Face for Medical Billing Fraud?
There are severe penalties associated with billing fraud. You could be charged a fine of $22,000 for every claim. That is why many people end up paying hundreds of thousands of dollars. You could also spend up to five years in prison for every federal charge.
How Often Do the Investigations Lead to Charges?
Most people who are investigated for billing fraud are not indicted. The vast majority of investigations do not lead to a conviction. However, the best thing that you can do is to hire an attorney.
Defenses to Medical Billing Fraud
- No knowledge-You have to know that medical fraud is going on. If you did not have any knowledge of what was going on, then you cannot be charged with fraud.
- Coercion-If you were coerced into medical billing fraud, then you may be able to get your charges dropped.
- No intent-Intent has to be proven. If you did not intend to commit fraud, then you may be able to get your charges dropped.
There are also people who can falsely accuse you of medical billing fraud. This includes the insurance companies, government agencies and patients. Regardless of the circumstances surrounding your case, you will need the help of a medical billing fraud defense attorney.
Our Billing Fraud Lawyers Will Fight Hard for Your Rights
The circumstances surrounding your case will determine the type of punishment that you will get. You may have to spend several years or jail or pay thousands of dollars in fines. Your attorney understands the law and will help protect your rights.
Your attorney will get started by performing a confidential case assessment. After that, they will determine the best course of action for you to take.