Fraudulent medical billing and insurance fraud are major threats in the US healthcare sector. Comprehensive medical record review can help expose false medical claims.

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The Looming Threat of Fake Health
Insurance Claims in the US
Fraudulent medical billing and insurance fraud are major
threats in the US healthcare sector. Comprehensive
medical record review can help expose false medical
claims.
A recent report in Yahoo News threw light on the actual
and alarming existence of health insurance fraud in the
United States. The estimate is that the state of Florida alone
incurs a huge amount of more than a billion dollars a year
as costs of personal injury fraud. This loss is passed down
to the consumer who is faced with higher insurance
premiums.
The article traces the actions of agents and police officers
on a mission to arrest around 20 people who they suspect
are part of a personal injury insurance fraud ring. The
modus operandi of the fraudsters is staging accidents where
obviously no one gets hurt. Physicians, medical clinic
owners, therapists and alleged accident victims are all said
to work together to fake car accidents and secure money
from insurers. As mentioned in this report, the passengers
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who are not in fact injured go to the personal injury clinic
that has been set up by the fraudsters to receive their share
of the money while the healthcare providers submit claims
for up to $ 10000 per person for treatments that were never
provided. The really distressing thing is that for a perfectly
orchestrated car collision, a car with 4 passengers could
easily bring in $ 40,000.
Government Disclosure about Healthcare Fraud
The FBI website highlights healthcare fraud as a major
threat to the well-being of American citizens and the
overall economy of the nation. Such fraudulent activities
cost the country an estimated $80 billion a year. What is
rather unnerving is that there are medical professionals who
are willing to risk patient safety by getting involved in such
schemes. In May this year, Attorney General Eric Holder
and HHS secretary Kathleen Sebelius announced that the
Medicare Fraud Strike Force had carried out operations in 8
US cities and brought in charges against 89 individuals that
included physicians, nurses and other licensed medical
professionals for participating in Medicare fraud schemes
that involved around $223 million in false billings. False
claims were submitted to Medicare for medically
unnecessary treatments and for treatments that were never
provided. It was seen that Medicare beneficiaries, patient
recruiters and other joint conspirators in the schemes were
paid cash kickbacks in return for providing beneficiary
information to healthcare providers. These providers would
then submit false claims to Medicare for services that they
never performed or that were medically unnecessary.
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In the various coordinated takedowns by the Medicare
Fraud Strike Force, at least 600 individuals have been
charged for partaking in schemes involving almost $ 2
billion in fraudulent medical billing.
Comprehensive Medical Record Review Can
Expose Fraudulent Medical Claims
It is true that healthcare fraud exists in enormous
proportions, and people who have sustained injury often
approach attorneys in relation to their personal injury
claims. It is important that the details of the injury
substantiate the accident. This can be ascertained only
through a thorough medical record review. A
comprehensive review of the medical documents can throw
light on all aspects of a personal injury case and identify
misleading information, ambiguous information, missing
information and other anomalies in the medical records. A
medical record review company with its professional
medical review staff can locate any tampering within the
medical records including fraud and billing errors.
When it comes to settling medical claims, detailed medical
record evaluation has an important role to play.
Professional medical review services help to properly
organize the medical records provide the chronology and
summary and opinion of the records for law firms, establish
the authenticity of the medical claims, and thereby ensure
that patients who have been really injured are represented
well, while fraudulent claims are exposed.
http://www.mosmedicalrecordreview.com/
1-800-670-2809