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Medicate Fraud: what is it and how can you avert it?

Digital harbor557 25-Jun-2019

Medicate Fraud: what is it and how can you avert it?

There are different types of frauds prevailing in the present world. If you are taking proper precautions then you are safe but otherwise you might be the next victim of fraudsters. Have you ever heard about medicate Fraud?

Well, medicate fraud is an attempt to get more benefits or payments than one is entitled to by means of a willful false statement, a headstrong misrepresentation, concealing material facts, or by a fake scheme. Of course, there are professional fraud prevention services like Digital harbor that can avert such frauds from taking place. But if you are not taking any assistance in fraud prevention then you might become a victim of impostors soon. The following examples are a tiny specimen of the kinds of fraudulent schemes providers have attempted:

- Substituting or misrepresenting the things or items billed;

- Billing for drugs, services, supplies or equipment that were not furnished, or were of cheap or lower quality;

- Ordering needless services;

- Calling for the Medicaid recipient to come back to the office of provider, even when it's obvious additional appointments are not essential

- Catering a set amount of services based on time and then billing for more or extra time than was really provided;

- Repeated billing for supposedly covered items, which were not really actually covered;

- Improper coding, i.e., supplying a regular office visit but billing for something extra or more;

- Medical identity theft

- Billing for office visits that didn't actually take place;

- The payment of kickbacks for the referral of a recipient to a specific provider;

Certainly there can be many more type of similar frauds. You have to be careful about them or you might find yourself cheated down the lane.

How can you spot Medicaid fraud?

In case you receive an Explanation of Benefits (EOB) from that of Medicaid, read it carefully. In case the information is not right or is different than the services you got, contact the Medicaid office displayed on the bill. In case a provider suggests treatments or services that you do not feel are essential, it is okay to be careful of the recommendation and to simply and confidently ask for a second opinion.

If you are naïve and you have no idea what to do and where to start from then you should take assistance of professionals like dharbor. These experts can help you in finding out the apt solution for your condition. If you think that you can prevent the frauds yourself then it is fantastic but if you have even a smidgen of doubt about the fraud prevention capabilities of your staff members then you must not hesitate to take help of professional services. After all, these experts have professional tools and advanced solutions to get you out of the tricky zones and guard your business.

Conclusion

Thus, prevention is better and you cannot take it lightly. You never know if you might have already been a victim of fraud unknowingly!



Updated 25-Jun-2019

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