Recover Your Money From Health Care Fraud Without Lawyers

Fight Medical Fraud Recover Your Money From Health Care Fraud Without Lawyers

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 overbilling. Malicious healthcare personnel benefit greatly from the excess funds, as many patients rarely understand the CPT codes. If you suspect upcoding has been committed, you might be thinking of hiring a healthcare fraud lawyer.

Fighting upcoding is challenging as the unscrupulous medical staff execute their activities carefully. They will deliberately frustrate all your efforts to have the CPT codes corrected. In most instances, you are likely to give up, leading to painful losses. On the other hand, involving third parties is costly and time-consuming. You might end up spending more money than you are pursuing.

Fortunately, you can use DoNotPay’s "Fight Medical Fraud" product to report upcoding medical fraud and demand bill correction.

What is Upcoding?

Upcoding entails reporting wrong CPT codes for medical procedures conducted on patients to inflate their medical bills. Doing so prompts patients to pay inflated medical bills for procedures they never underwent. Upcoding is a serious compliance offense, leading to payer audits, reimbursement takebacks, penalties or license revocation.

Unfortunately, most upcoding crimes are intentional, as malicious healthcare personnel collude with the accountants within the facility to defraud unsuspecting patients.

Upcoding Consequences

Upcoding has serious social and legal ramifications for the perpetrators and victims involved. Some of the consequences include:

  1. Lawsuits and penalties in the Small Claims Court
  2. Healthcare facility losing public confidence and loyalty
  3. Loss of money for unsuspecting patients
  4. Inconsistencies during auditing can lead to a legal battle for unaccounted funds.

The Federal Government is the major casualty of overbilling as malicious staff take advantage of Medicare and Medicaid health incentives. The Government Accountability Office has established stringent measures to counter upcoding.

Preventing Upcoding

Health care facilities caught engaging in upcoding suffer greatly. Although malicious staff are responsible for the vice, the healthcare facility loses public confidence and loyalty. For this, it is crucial to prevent upcoding instead of dealing with the consequences.

Healthcare executives can prevent consequences associated with upcoding by conducting random internal audits of the facility's CPT coding, billing and documentation practices. Doing so reveals any inconsistencies in billing and documentation. This allows the management to deal with unscrupulous employees internally before being exposed externally.

You can also involve a medical billing company to handle coding and billing on your behalf. Doing so eliminates the risk of your employees conducting errors. It also creates accountability within your institution, as you can hold specific persons accountable for upcoding. Preventing upcoding within the institution saves you a lot of money in the long term and sustains your reputation as an institution.

How to Report Medical Fraud?

If you suspect you are an upcoding victim, contact your healthcare provider for clarification. If they are uncooperative, report them to relevant institutions. You can file your complaint to the Health and Human Service Office of the Inspector General:

By Phone1-800-HHS-TIPS, (1-800-447-8477) or

TTY: 1-800-377-4950

OnlineSubmit a complaint
By MailOffice of Inspector General


P.O. Box 23489,

Washington, DC 20026.

You can also sue your healthcare provider in the Small Claims Court. However, ensure that your case meets the threshold to be heard in the small claims court. Hiring a competent healthcare fraud lawyer to represent you in court is advisable.

Reporting Medical Fraud Using DoNotPay 

Reporting medical fraud yourself is daunting and time-consuming as you are likely to encounter many hurdles and do numerous follow-ups. Unfortunately, hiring a competent healthcare fraud lawyer to represent you in the small claims court is costly.

Luckily, you can use DoNotPay to solve your upcoding case successfully. DoNotPay uses its influence to compel the medical facility to correct the CPT code to ensure you pay the right bill. If the physician is uncooperative, DoNotPay can guide you on how to sue in small claims court.

Follow the steps below to address the medical fraud successfully using DoNotPay: 

  1. Search Fight Medical Fraud on DoNotPay.


  2. Tell us the date of your visit, what you were treated for, and where you were treated.


  3. Let us know what CPT code your visit was filed under. If you don't know, we'll generate a letter for you to send to your physician to request the code.


  4. Choose the correct CPT code or let us know if you want us to find it for you.


  5. And that's it! DoNotPay will automatically find the correct CPT code for your visit if you don't know it and then generate a demand letter on your behalf to send to your physician for a bill correction.


DoNotPay Works Across All Medical Companies and Health Facilities With the Click of a Button

The world’s first ever robot lawyer can help you get the correct CPT code in New York as efficiently as it can in Texas. DoNotPay can get the best possible results from any medical facility across the US. You can also use DoNotPay to:

What Else Can DoNotPay Do For You? 

DoNotPay is your perfect consultant when dealing with social and legal issues. Some of the social and legal services DoNotPay provides include:

Sign up to DoNotPay today to solve any medical problems that have been weighing on your shoulders.

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