How To Detect And Prevent Healthcare Fraud And Abuse?

Our straightforward guide equips you to fight healthcare fraud and abuse. Phantom patients and upcoding are examples of red flags that must be recognized.

Introduction

This issue poses a substantial risk to individuals, insurance providers, and the industry. This article navigates the intricate landscape of healthcare fraud and abuse, presenting case studies and offering actionable recommendations for identifying and tackling these illegal acts.

Understanding Healthcare Fraud and Abuse

The phrase healthcare fraud and abuse describes immoral actions within the healthcare system. Deception and nonconformity define abuse, whereas misrepresentation is a deliberate act. Both possibilities can lead to sizable financial burdens and subpar patient care.

Top 10 Healthcare Fraud Examples

Certainly! Here are top 10 examples of healthcare fraud that individuals should be aware of.

Billing for Services Not Rendered

It has been observed that healthcare providers occasionally charge their patients for services that have not yet been rendered, which includes physical therapy sessions that the patients did not utilize. This practice could have an adverse impact on the patient’s financial situation and their trust in the healthcare system. Read More...


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