More on Fraud: Illegal Procedures
Posted By Administrator
Other fraudulent procedures include:
- charging for services that were not performed
- unbundling of claims: where a series of procedures that may be covered by a single fee is charged separately for higher fees
- double billing: where a service is charged twice
- upcoding: where a more complex procedure is declared and billed for a simple procedure actually done
- miscoding: where a wrong code is used for a procedure
- kickbacks: where payment is received for making a referral, usually the payment for such referral is sourced from an overcharged procedure, and is “kept hidden” by declaring these as mere rental payments.
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