For some reason is best known to people who engage, fraud is very app[rent in our different healthcare institutions. Fraud happens in different procedures of the medical field. Fraud could take the form where a dishonest care provider falsifies sensitive information in the medical records of the patient with the hope they will be reimbursed for the services provided. Fraud could be in the form of carrying out unnecessary procedures on the patient or tests. The cases of fraud in healthcare institutions are on the rise and its only right that you know what to be on the lookout for so that you don’t fall victim to them. It doesn’t matter the kind of healthcare insurance you have, you can become a victim of fraud.
Its these cases of fraud that drive the cost of healthcare up denying some people the cover. It has come to a point that people have to rise against healthcare fraud because luckily there is something that people can do. Signatures of doctors and other healthcare providers sometimes could be forged so that reimbursements can go through. It is also wrong for drugs to be billed and if they have not been approved for the patient. An insurance cover will have listed the services that it covers but some uncovered services could be renamed as billable which is wrong. If a procedure is billed as a whole, dishonest health care providers could start billing it step by step to get reimbursed more.
Medical service being overbilled is certainly not new, but in this case dishonest health care providers will even waiver deductibles that people are entitled to. Monitoring on different levels needs to be exercised if the battle against fraud in healthcare is to see some progress. 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 technologies will also help with this problem especially backed by the fact that it has worked in other areas.
With automation you save yourself a lot of fraudulent cases, the key here is to limit human interaction especially when dealing with payment. Auditing can also help with some cases of fraud especially the kind that leaves some bits of evidence in the system. Reporting of cases of fraud will also help in discouraging any such activities in the future. Many might not realize it but there are platforms that are available for clients to report such cases. 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.
