You may think you would know if your healthcare practice utilized fraudulent services. However, you may not realize your practice is committing fraud until you receive legal notice. It is important to make sure you do not unknowingly commit healthcare fraud.
Healthcare fraud can take many different forms, and you can benefit from knowing these.
Working with excluded physicians
According to the U.S. Department of Health and Human Services, you might commit healthcare fraud if you work with a medical professional who cannot work with Federal health programs. Medical professionals are not allowed to take part in programs like Medicare if they have a criminal conviction related to healthcare.
While you may not have this type of offense n your record, you should make sure your employees do not have medical offenses on their records. You may also want to screen the medical contractors you are considering working alongside. This is because excluded doctors cannot send bills to federal health programs. Your practice may have to pay these expenses if you unknowingly work with an excluded physician.
You are not allowed to receive any type of reward for referring patients to a specialist or for prescribing certain medications. Sometimes you may unknowingly accept kickbacks. For example, drug company may ask you to serve as a consultant. This relationship could be fraudulent if the company expects you to prescribe certain treatments to your patients. Before collaborating with other companies, you may want to consider the arrangement from all angles.
Protecting your practice
If you realize that some of your services or business relationships may be fraudulent, it is important to take action. You should stop working with medical companies as soon as you think their practices may be unethical. If you think someone at your practice is committing healthcare fraud, you may want to perform an audit so you can identify and resolve the problem.