Can I Recover Money From Medical Billing Scam? Here's How!

In the United States, medical bills are very expensive. Therefore, receiving a large medical bill may not seem like a big deal. The problem is that doctors can overcharge for their services. You need to know what to look for to ensure you're not a victim of a medical billing scam . Most people do not [. . .]

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Upcoding and Downcoding: Definition, Examples, How to Avoid

Medical fraud has been increasing at alarming rates in the recent past. Two major types of medical fraud include upcoding and downcoding . Upcoding involves overbilling a patient, while downcoding is the reverse of upcoding. It entails under-billing patients. Upcoding disadvantages patients as they [. . .]

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Preventing Medical Billing Fraud—Everything You Should Know

Health insurance is crucial for helping millions of U.S. citizens pay for essential doctor's visits, surgeries, and prescriptions. This means that many people will do everything to learn about preventing medical billing fraud . A common example is when healthcare providers claim that your required healthcare [. . .]

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5 Types of Medicare Fraud and What To Do If You're a Victim

When most of us think about our doctor or our chosen medical facility, we don't think about deception. However, many doctor’s offices are playing a game with insurance companies which means they are committing Medicare fraud. You should arm yourself with knowledge by knowing the common types of Medicare [. . .]

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Get Money Back From Medical Billing Fraud Without a Lawyer

Imagine you're returning home from a short hospital stay for routine surgery. Let's say you had a standard surgery like an appendectomy. A few weeks pass before the medical bills and benefit statements arrive in the mail. Right away, you notice something is wrong. Your statements reflect all sorts [. . .]

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How Is Upcoding Being Monitored By Payers?

The US healthcare system relies heavily on third-party payers. Between private health insurance companies, federal programs like Medicare and Medicaid, and state-run programs like California's MediCal, most patients pay only a small portion of their medical costs. At first, this seems like a favorable [. . .]

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What Does The False Claims Act Say About Medicare Frauds

Medicare has provided life-saving treatment for younger disabled individuals and senior citizens. Under the Medicare False Claims Act , no healthcare provider should force you to pay for services that weren't performed. However, some shady doctors will try to defraud Medicare users by assigning incorrect [. . .]

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What Are Defenses For Health Care Fraud Victims?

A healthcare accusation is an expressway to a complex and overwhelming situation. The situation is challenging to navigate, fight, and hard to get away with. Federal prosecutors are becoming more creative with discoveries of how they can prosecute and charge healthcare fraud. To ease the burden of fighting [. . .]

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What To Do If You See Someone Upcoding For Insurance?

Most people know that there are scams we must watch out for in today's world  There are phone scams, email scams, and more. What we don't think about is insurance scams perpetrated by our doctors, but it happens. Do you know what to do if you see someone upcoding for insurance ? DoNotPay has the answers [. . .]

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Medicare Fraud Penalty — Everything You Should Know

Federal authorities are increasingly focusing on prosecuting Medicare fraud. The FBI recently apprehended suspects for allegedly defrauding Medicare to a tune of over $1 billion. According to the centers for Medicaid and Medicare services, over 2,100 individuals have been charged with Medicare fraud. [. . .]

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Recover Your Money From Health Care Fraud Without Lawyers

If you have been forced to pay inflated medical bills for services not rendered, you are a victim of upcoding – one of the major types of medical fraud conducted in medical facilities. It entails overquoting CPT codes for medical procedures a patient undergoes in healthcare facilities leading to [. . .]

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Why Should You Care About Health Insurance Fraud

Healthcare insurance fraud affects everyone . The Centers for Medicare and Medicaid Services (CMS) spent $1.1 trillion in one year on health coverage for 145 million Americans, according to the American Medical Association (AMA). The most shocking revelation though comes with the fact that $95 billion [. . .]

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Upcoding & Undercoding: Definition, Examples, How to Avoid

If you've purchased your health insurance (or are eligible for Medicare) you should be able to visit a doctor without worry. However, patients can still fall victim to unsavory practices like upcoding and undercoding, not to mention unbundling. All of these terms refer to types of medical billing fraud: [. . .]

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What Happens If I Know of Medicare Fraud and Don't Report It

In legal terms, if you know Medicare fraud is occurring but don't report it, you're acting as an accessory after the fact. If you're employed as hospital staff or a nurse, you're acting unethically and unlawfully. You also expose yourself to professional risk because you might be implicated when someone [. . .]

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5 Common Types of Fraud In Health Care You Need to Know

Get Your Money Back From 5 Common Types of Fraud In Health Care Directly and indirectly, healthcare fraud affects all of us. For those who have not been directly involved, you have likely experienced increases in health insurance premiums and taxes due to various illegal healthcare schemes. However, [. . .]

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Get Your Money Back From Medicare Fraud Without a Lawyer

Medicare billing fraud costs US taxpayers around $130 billion every year. Sometimes, Medicare fraud occurs when someone else gets their hand on your Medicare beneficiary number and uses your identity to get the healthcare they need. That's tragic and unfortunate, but it's also hard to blame someone [. . .]

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Medicare Fraud Whistleblower: Role, Protection, and Rewards

Medicaid and Medicare fraud comprises the largest area of fraud against the government today. An average of 10% of all medical bills in the United States are fraudulent or inflated. This fraud is why the Department of justice compensates large whistleblower rewards to anyone who reports Medicare fraud. [. . .]

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What Is the Monetary Reward for Reporting Medicare Fraud?

In the US, the Centers for Medicare & Medicaid Services (CMS) pay a reward for reporting Medicare fraud worth more than $100. The total reward amount is up to CMS, which doesn't publish any guide to respective amounts. CMS states the reward amount will be based on the money saved when the Medicare [. . .]

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How to Report Upcoding the Easy Way

Upcoding may sound like a new vocabulary, but in Medicare, it is a severe and frequent fraudulent offense that has caused immense losses to the federal government every year. Medicare officials have been stealing from American taxpayers and senior citizens through upcoding. Upcoding is a form of fraud [. . .]

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Is Your Dental Bill Higher Than Expected? It May Be Upcoded!

Upcoding is a type of fraudulent medical billing in which a charge for health treatment is provided that is more expensive than it should have been based on your service. An upcoded bill can be sent to any payer, including a private health insurer, Medicaid, Medicare, or the patient. Upcoding could [. . .]

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What's the Liability to Report Medicare Upcoding?

Every person and health care provider has a liability to report Medicare upcoding fraud and other forms of health care fraud. Medicare medical fraud costs the government and taxpayers a lot of money, thus making it a cause for alarm. Criminal healthcare fraud such as upcoding and unbundling attracts [. . .]

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Upcoding — Definition, Examples, and How to Fight Back Now

We all know that medical bills can be expensive. Therefore, you may not think twice about a bill that seems excessive. However, in today's world, you must look carefully to protect yourself from overcharges and upcoding. Upcoding is a form of Medicare fraud. It is a way that doctors can get paid a little [. . .]

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Report Medical Billing Fraud and Correct Your Bills Instantly

When you visit a doctor or a medical facility, they write your entire visit out in codes. These codes make medical billing straightforward, but they also make it possible for your insurance to be overcharged. If you're concerned about medical bills you've received, you should know how to report medical [. . .]

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How to Report Medicare Fraud and Get Your Bills Corrected

For every medical procedure including a checkup by your doctor, a laboratory test, x-ray, scan, surgery, etc. there is a current procedural terminology (CPT) code. These codes are assigned by the American Medical Association (AMA) and are copyrighted. Why does this matter? When you have any form of medical [. . .]

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How to Get Money Back If You Are a Victim of Medicare Fraud

Medicare, a federal health insurance program, is available to individuals aged 65 and older or some people with disabilities or End-Stage Renal Disease. If you or a loved one receive Medicare, you know how it can help pay for hospital or skilled nursing facilities, doctors' services, medical supplies, [. . .]

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Medicare Fraud — Definition, Examples, and How to Fight Back

Medicare medical fraud is a massive problem in the US, and taxpayers end up paying the price. But you don't need to sit idly by and watch this abuse happen. You can report Medicare fraud by yourself or use the DoNotPay app. The good news is that healthcare fraud can be prevented and reported, and DoNotPay [. . .]

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Can You Get Money Back from Health Care Fraud? Here's How

Can You Get Money Back from Health Care Fraud? If you or a loved one has recently had an emergency room visit or healthcare treatment, and your bill looks unusually high or suspicious, you are not alone. If you suspect any type of healthcare fraud , you should act immediately. However, not everyone [. . .]

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Upcoding and Unbundling: Definition, Examples, How to Avoid

Healthcare practitioners use CPT codes for roughly 7,800 different procedures. These codes represent all operations, ailments, and medications that are now reimbursable by health insurance. A costly and prevalent kind of healthcare fraud, upcoding is only one of several. Are you concerned about the cost [. . .]

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