The Danger of Overbilling

As a medical practice, billing errors happen. Although mistakes with billing errors can be common, at times they can also be purposeful. For example, a medical practice may decide to overbill in order to collect higher reimbursements from insurance companies. In order to avoid the repercussions that come with medical billing fraud, it is important to have office staff that are trustworthy and honest. Additionally, it is important to have office policies that uphold a high level of ethics. Types of Fraudulent Overbilling When it comes to overbilling, there are several examples of overbilling that are considered fraudulent and medical practices need to avoid at all costs. These include the following:

1. Billing for unnecessary services
2. Over-diagnosing
3. Billing for services not rendered

  Although at times mistakes can be made, recurring billing errors should be addressed. If your practice has an influx of patient complaints in regards to their bill, this could be a red flag.   How to Report Overbilling Errors If overbilling occurs, it is important to fix the error as soon as possible. The first step in doing so is to speak with the billing department. If the billing representative is unable to shed light on the error and how the mistake was made and you suspect that a scheme may be taking place, it may be necessary to take additional steps, such as the ones below:  

• Report the matter to the chief financial officer
• If you believe that a fraudulent scheme may be taking place, contact The National Health Care Anti-Fraud Association (NHCAA)
• If you believe the physician is involved, contact your state’s medical board to file a report

  Let AMS Help Just like any other business, a medical practice needs revenue to keep the doors open. When cash flow problems occur, it may be tempting to overbill to recoup lost income. However, this is never the answer. If your practice is struggling with patient billing, hiring a well respected billing company, such as Applied Medical Systems (AMS), may make all the difference. AMS is an expert when it comes to medical billing services and specialize in helping their clients get paid faster. Additionally, AMS offers value-add services to the clients, such as consulting services, that can aid in getting the practice running smoothly and efficiently.   Learn More We invite you to explore AMS and our list of services. We offer complimentary quotes, so be sure to request yours today. We look forward to learning more about your practice.