Re: Proven Methods To Reduce Medical & Dental Costs
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> 38 Proven Methods To Reduce Medical & Dental Costs
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Proven Methods To Reduce Medical Costs
Encourage patients to verify alleged services performed by doctors who
are charging patients (especially Medicare and Medicade) for services
not actually performed. ( I recently turned in a cardiologist who had
to return the money.) It amounts to billions of dollars.
Examples of Medicaid Provider Fraud
DOCTORS
DENTISTS
CHIROPRACTORS
PODIATRISTS
OPTOMETRISTS
NURSING HOMES
HOME HEALTH CARE
ADULT FOSTER CARE (AFC) HOMES
HOSPITALS
PSYCHIATRIC HOSPITALS
SUBSTANCE ABUSE CLINICS
PHARMACIES
DURABLE MEDICAL EQUIPMENT
LABORATORY SCAMS
KICKBACKS
MOBILE LABORATORIES
AMBULANCE SERVICES
--------------------------------------------------------------------------------
DOCTORS: : [Return To Provider Example List]
Bill for services not provided, i.e. a chest x-ray when an x-ray was
not taken.
Duplicate Billing occurs when a provider bills Medicaid and the
recipient or private insurance for the same service.
Requires that the patient come back each week for the same problem or
to get the same prescription when another appointment is not
necessary, or a normal amount of medication could be prescribed.
Upcode, i.e. identify a simple office visit as an emergency office
visit or a comprehensive visit.
Take unnecessary x-rays, blood work or perform other unnecessary
services.
Bill Medicaid for an office appointment when you did not have an
appointment, or add additional family members' names for appointments.
Have an unlicensed person perform services that only a licensed
professional should render, and bill as if the professional had
provided the service.
Billing for more time than actually provided, ie counseling,
anesthesia, etc.
Alter date of service for billing purposes
Cont'd
http://www.michigan.gov/ag/0,1607,7-164-17334_18152-46063--,00.html
Related Content
• About The Health Care Fraud Division
• How To Identify & Report Medicaid Provider Fraud
• How To Document & Report Vulnerable Adult Abuse/Neglect
HOSPITALS:
Billing for services not rendered.
Substituting generic drugs and billing for name brand medications.
Substituting medical resident doctor services and billing for licensed
medical practitioner services.
Billing for more days than actually used.
Billing for lab procedures not used.
HEALTH; Dishonest Doctor Bills
NY TIMES
HEALTH; Dishonest Doctor Bills Provoke New Campaign
By ROBERT PEAR, Special to the New York Times
Published: Thursday, December 3, 1987
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Insurance companies and Government officials have joined in a new
effort to fight dishonest billing practices used by doctors to obtain
payments for themselves or their patients.
Experts said the problems ranged from seemingly innocuous situations
in which a doctor fabricates a diagnosis or exaggerates a complaint to
help a patient obtain reimbursement for a routine examination to more
serious cases in which doctors submit claims for services not
performed.
Cont'd
http://query.nytimes.com/gst/fullpage.html?sec=health&res=9B0DEED6173EF930A35751C1A961948260
Let us prey.
"Greed is good."
-- Gordon Gekko