In pursuit of Fraud free Healthcare
Unfortunately, the ugly face of fraud shows up in the industries least expected, health care. Fraud happens in different procedures of the medical field. Medical fraud involves dishonest healthcare providers fixing vital information with the hope of being reimbursed for services that they have offered the patient. These could be cases where the doctor or another healthcare provider does unnecessary tests and procedures which the patient does not need. It will be in your favor if you know the indicators of fraud especially now that the cases are at an all-time high. Fraudulent dealings are not tied to people with a certain kind of medical insurance, it could be anyone.
Its these cases of fraud that drive the cost of healthcare up denying some people the cover. It make it necessary for people to wake up to this realization and do something about the situation. Healthcare fraud goes beyond patents and healthcare provider interaction, physicians signatures could be falsified especially in cases where they are required for reimbursement to be successful. It is also wrong for drugs to be billed and if they have not been approved for the patient. Some services that an insurance cover would not pay for could be disguised in other terms so that they are paid for fraudulently. In other instances fraudulent healthcare providers will bill medical procedures step by step which is wrong.
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. To fight fraud in the healthcare system, there needs to be evaluated at different levels. 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. Other industries that have a hard time dealing with fraud have made use of fraud detection technologies with success, the health care industry could also apply the same.
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. 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.