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How to avoid healthcare fraud charges

On Behalf of | Sep 24, 2022 | Medical Malpractice

If you are a practicing physician, practitioner or medical insurance provider, you no doubt are often in possession of patient information, medical records and billing invoices. In each of these fields, your expectations are to provide quality care and honest service. If a West Virginia patient believes that you have acted unlawfully, you could wind up facing healthcare fraud charges in court.

To avoid such legal problems, it’s critical that you understand state and federal laws that are relevant to medical practice and healthcare insurance issues. It is also important to be aware of the issues that constitute healthcare fraud. The more you know about the topic, the easier it might be to steer clear of trouble.

Healthcare fraud charges often occur in connection with the billing process

As a physician, you deserve to receive compensation for your services. Your patients, however, also deserve fair treatment, especially when it comes to billing. Many doctors and insurance providers encounter legal problems when patients accuse them of billing for services that were not provided or filling upping costs, meaning billing for a more expensive service than the one that was actually provided.

These billing infractions are types of healthcare fraud. It is far less likely to have complaints filed against you if you make sure that bills being sent to patients are accurate.

You are committing healthcare fraud if you order unnecessary tests for profit

As a physician, it would not be out of the ordinary for you to order certain tests to rule out or confirm specific conditions. Doing so is a common practice that may help you form an accurate diagnosis for a patient. Ordering tests that are medically unnecessary or falsifying medical records to justify such tests is a form of medical malpractice.

You might think it is best to order some tests ” just to be safe.” However, you might find yourself facing fraud charges if a patient thinks you were ordering tests without merit.

Facing fraud charges can damage your career

Being accused of healthcare fraud in West Virginia or any other state can have an immediate and long-lasting negative effect on your career. If you are a physician, it can also place your license at risk. As a professional, your reputation has a direct impact on your success in the industry.

Facing fraud charges is not only stressful, it can be a downright frightening experience. The court must provide you an opportunity to present a defense, so the sooner you explore your options, the better. In such circumstances, you would want to make sure you clearly understand all that is at stake, as well as any laws or regulations that are relevant to your case before proceedings begin.