Fraud Expert, Linda Webb, aka The Fraud Dog, says that the fraudster will find any loophole they can in order to steal. One-third of every dollar in our health care system goes to the fraudster and something must be done to stop it. Here are five ways the fraudster steals in the medical provider industry:

  • Upcoding
  • Phantom Billing
  • Inflated hospital bills
  • Service Unbundling
  • Self-Referrals.

Upcoding refers to improperly coding the severity of the injury to make it seem as though the injury is more serious in order to receive higher compensation for the treatment. Phantom billing is billing for services that were not actually preformed. Inflated hospital bills refers to gross overcharges in medical bills. Services Unbundling occurs when multiple procedures that should be packaged into one charge are separated into different chargers, which would create a higher invoice. Lastly, self-referral occurs when a doctor refers the patient to himself or another doctor in his or her same practice for testing and receives compensation for those tests.

Our call to action for every American is to review your medical bills and report anything you see that might be suspicious. Request an itemized copy of your medical bills. Indeed reading one’s medical bills may not always be the easiest to interpret, but if you see anything that doesn’t seem right, then please speak out and report it. It is time we sent a message back to the fraudster that America is tired of escalating health care costs due to fraud. Together we can send the fraudster packing.

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