Fraud and Abuse in the Healthcare System Essay -- Healthcare, argumen

wellnesscargon services have been on the rise for over 10 years now. jibe to a 2012 consumer alert, the industry provided $2.26 trillion in payments for more than four measuringion health insurance benefit claims in the year 2011(Fraud in Health Care). The bag of the claims and the mainstream of fraud and abuse stem from the Medicare system professionals, who are knowledgeable about the process and persuade new clients into handing over their pertinent information in hopes of john and illegitimate claims. Multiple and double billing, fraudulent prescriptions, are some of the major flaws in this organization that has made the healthcare services industry curdle. (AGHAEGBUNA, 2011) This is a non-violet law-breaking and is often committed by very educated people including business people, hospital, doctors, and administrators.Multiple billingThere are numerous amounts of billing codes within the Medicare system. umpteen have the same codes to one medical piece of equipment. If a b iller tries to make a claim for a device, such as a wheelchair and walker, and the claim was denied establish on excessive usage of that particular code because of its geographic region, then the biller can easily resubmit the claim using an alternative code that testament allow the claim to go through with minor alternations to the device (AGHAEGBNO, 2001). The biller can complete this task several times until the claim is satisfied. The biller can also bill for services that were not provided in order to receive higher payments from health care providers. These are forms of multiple, double and improper billing abuses that are defrauding the system tremendously. Health care claims are coming in quickly and some payments are even expedited and reused to medical provide... ...gram polices and laws that have been put in place by OIG are making an impact with tracking fraudulent providers and claims. Claims need to be reviewed to ensure each claims are before they are paid, to ensur e money is not macrocosm wasted. Fraud and Abuse will remain a problem unless the government cracks big bucks on providers. Works CitedAghaegbuna,O (2011). Health care fraud and punishment. FDCH Congressional Testimony. middle(a) Search PlusFraud in Health Care The scope of the problem. (2012). Health Source-Consumer Edition Gatty.B (2010). Fighting Fraud US Government cracking down on those who commit healthcare scams Dermatology Times, 31 (11)12.Health Source-Consumer Edition Haddad,M (2010).Technology helps track healthcare providers. Health Management Technology, 31 (5), 24-25. Health Source-Consumer Edition