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

Healthc atomic number 18 services have been on the work up for over 10 years now. According to a 2012 consumer alert, the industry provided $2.26 billion in payments for more than four billion health insurance realise claims in the year 2011(Fraud in Health consider). The bulk of the claims and the mainstream of fraud and affront stem from the Medicare system professionals, who are knowledgeable about the process and bear new clients into handing over their pertinent information in hopes of deception and mongrel claims. Multiple and paradigm 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 wickedness and is often committed by very educated people including line of reasoning people, hospital, doctors, and administrators.Multiple billingThere are numerous amounts of billing enrols at bottom the Medicare system. Many have the same codes to one me dical checkup piece of equipment. If a biller tries to make a claim for a device, such as a wheelchair and walker, and the claim was denied based on excessive usage of that particular code because of its geographic region, then the biller can easily resubmit the claim exploitation an alternative code that will allow the claim to go finished with minor alternations to the device (AGHAEGBNO, 2001). The biller can complete this task several measure 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 make an impact with tracking fraudulent providers and claims. Claims need to be reviewed to ensure each claims are before they are paid, to ensure money is not be wasted. Fraud and Abuse will remain a problem unless the disposal cracks down on providers. Works CitedAghaegbuna,O (2011). Health care fraud and punishment. FDCH congressional Testimony. Middle Search PlusFraud in Health Care The scope of the problem. (2012). Health Source-Consumer translation Gatty.B (2010). Fighting Fraud US governing body cracking down on those who commit healthcare scams Dermatology Times, 31 (11)12.Health Source-Consumer magnetic declination Haddad,M (2010).Technology helps track healthcare providers. Health Management Technology, 31 (5), 24-25. Health Source-Consumer Edition