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Steps to take to help your health care practice avoid fraud

On Behalf of | Jul 6, 2020 | Medicare & Medicaid |

Our nation’s health care system has grown more complicated. And with these complexities come increased chances for illegal and negligent activity within health care organizations. With this in mind, health care providers must take it upon themselves to prevent fraudulent activity before it happens.

Your practice, employees, livelihood and reputation must be protected. If not, you could lose all of them as well as your professional license. Crucial safeguards in place can help prevent illegal activities, so you need to be pro-active.

Understand the laws, focus on accurate billing and records

Here are some of the steps to take to avoid fraud within your health care practice:

  • Have a thorough understanding of health care regulations. This includes the False Claims Act, a federal law making it illegal for people or companies to submit false claims related to federal health care programs such as Medicare and Medicaid. An example would be submitting false claims to the government for reimbursement for certain medical services.
  • Accurate billing is a necessity. Although you may have a person whose responsibility is medical billings, it is crucial to have an extra safety net. Hiring an independent third-party to audit your records can eliminate any overcharges and inaccuracies as well as identify suspicious activity such as charging for services not rendered.
  • Accurate records for rendered services is a must. They not only help your practice and prove that treatments have taken place, but also assist in defending you against potential malpractice lawsuits.
  • Understand and avoid conflicts of interest. If they surface, though, disclose them immediately. Such a scenario may be accepting gifts from within the medical industry.
  • Have a compliance plan in place that would prevent fraudulent activities related to Medicare and Medicaid. This would include a section on auditing and internal monitoring.

Your health care practice will significantly benefit by implementing these steps. Take action, do your research and eliminate any potentially illegal activities.