When you first enter the medical profession, protecting yourself from accusations of fraud is probably the last thing on your mind. However, the problem is so prevalent that the National Health Care Anti-Fraud Association is dedicated to preventing and uncovering fraud in the healthcare industry.
While unscrupulous healthcare workers may intentionally set out to defraud patients, insurance companies and government organizations, healthcare fraud isn’t always this straightforward. In a significant number of cases, physicians may inadvertently commit fraud due to inaccurate reporting, billing errors and simple human errors.
If you want to protect your practice and your professional reputation, take a look at these top tips for protecting yourself from allegations of healthcare fraud:
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1. Understand the Law
There are numerous laws pertaining to healthcare fraud, including the False Claims Act, the Stark Law, Criminal Health Care Fraud Statute, the Anti-Kickback Statute and the Civil Monetary Penalties Law. By having a good understanding of the laws and regulations which govern the healthcare industry in relation to fraud, you can reduce the risk of inadvertently breaching them.
2. Seek Legal Advice
The law is complicated and can be difficult to apply in real-life situations. By seeking advice from reputable Medicare fraud defense lawyers - Healthcare Fraud Group LLC - you can make sure that you have a proactive plan in place to prevent accusations being made. While it’s always sensible to seek legal advice when an investigation is underway, you don’t have to wait for this to happen to retain a lawyer. Being proactive about healthcare fraud means you can avoid accusations and investigations from the outset.
3. Use Reliable Billing Methods
The most common forms of healthcare fraud include double billing and phantom billing. However, it’s easy to accidentally bill for the wrong procedures or treatments if you have an ineffective billing procedure. Similarly, two invoices can easily be sent out if your billing system is unreliable or an administrator makes an honest mistake.
Fortunately, healthcare software and programs are making it easier than ever to streamline billing processes and avoid errors. If you don’t have the in-house capabilities to handle your billing, you may even want to consider outsourcing your needs to a third-party medical billing company.
4. Audit Your Practice
Conducting an audit enables you to highlight any discrepancies and resolve any potential issues before accusations of fraud can be made. Using an external auditor or accountant to undertake this procedure will ensure there is no bias. Furthermore, willingly undergoing audits helps to show that you’re operating above board and in accordance with the relevant regulations.
5. Preventing Healthcare Fraud
The vast majority of healthcare workers are committed to providing patients with the very best care and treatments, and they do so honestly and genuinely. By overhauling your in-house protocols and systems, you can increase transparency within your practice and reduce the chances of fraud allegations being made against you. By doing so, you’ll alleviate the stress and costs associated with defending these types of allegations and protect your practice.
