Healthcare fraud costs Texans millions annually through improper Medicaid/Medicare claims, inflated costs, kickbacks, and other schemes that exploit health programs. Learning to identify the red flags of medical fraud can help expose the truth and reduce losses. If you think you are involved with fraud, a healthcare fraud lawyer can help you with the next steps to address the issue.
Billing for Services Never Performed
One of the clearest signs of healthcare fraud is being billed for care you never received. This includes charges for missed appointments you canceled, forged signatures on sign-in sheets, and invoices listing diagnostic tests that were never ordered or completed. Review bills closely and watch for providers billing your insurance for appointments that were canceled ahead of time, as these bogus charges are frequently a sign of fraudulent billing practices. You should also be suspicious if you start receiving bills for medical services that have no explanation or that you have zero recollection of ever receiving.
Upcoded Medical Bills
When a healthcare provider knowingly assigns the wrong service code to inflate costs, it is called upcoding fraud. Watch for charges that seem excessive given the basic or routine care received. Upcoding medical bills is illegal. Scrutinize any bill that seems to charge unusually high fees for straightforward, everyday medical services to check for fraudulent upcoding cheating you and your insurer. This specific type of fraud is more common than you may think.
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