In pursuit of Fraud free Healthcare
For some reason is best known to people who engage, fraud is very app[rent in our different healthcare institutions. Different medical practices could have cases of fraud . Medical fraud involves dishonest healthcare providers fixing vital information with the hope of being reimbursed for services that they have offered the patient. Fraud could be in the form of carrying out unnecessary procedures on the patient or tests. It will be in your favor if you know the indicators of fraud especially now that the cases are at an all-time high. It doesn’t matter the kind of healthcare insurance you have, you can become a victim of fraud.
The high cases of fraud makes medical insurance something that most people cannot afford. These facts are rubbing people the wrong and at some point it becomes necessary to do what you can to correct the situation. Signatures of doctors and other healthcare providers sometimes could be forged so that reimbursements can go through. If drugs being billed have not been approved, that is fraud too. Services that an insurance a cover does not cater for could be renamed so that they appear as billable. In other instances fraudulent healthcare providers will bill medical procedures step by step which is wrong.
The most common would be services being overbilled such that the insurance gets deducted more than should be the case, in other sad cases the deductibles a and co-pays that a patient is entitled to could be deliberately waivered. Since fraud happens at more than one level in the health care system, monitoring mechanisms need to be effected at the different levels to encourage accountability and honesty. Education and any form of training that can be provided on fighting fraud to the masses will come in handy as that will create alertness in people seeking medical services. Fraud detection is being applied in different industries, it is time it was also made to work in the healthcare arena.
Automation systems could also save a lot of inconveniences brought about by fraud. Proper auditing also needs to be done from time to time just to check and see that everything is in order. Anyone seeking services in a healthcare facility needs to know that they can make a report if they fall victim to cases of fraud. However it begins by letting the masses know that they can report such cases through channels that have been set. The biggest losses amounting from fraud in health care go to the patients and their insurance companies. Vigilance from patients will help with making healthcare professionals accountable for anything fraudulent happening on their watch.
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