What Health Care Providers Should Know About Billing Fraud


What Health Care Providers Should Know About Billing Fraud


Whether you’re a dentist, an orthopedic surgeon, or an eye doctor, medical billing is a component of your everyday operations. In America, health care providers typically collect a co-pay from patients, then submit the remainder of the claim to insurance companies or Medicaid and Medicare for reimbursement.

Medical billing fraud occurs when a health care provider or consumer submits false information with the goal of increasing the amount of this reimbursement, or gaining reimbursement when none is warranted. As trusted white collar crime attorney in Newark, the Law Offices of Robert J. Degroot has dealt with many medical billing fraud cases, providing expert advice and defense strategies that help keep health care providers in business.

No matter what services you provide, here’s what you should know about billing fraud.

It Costs The Economy Billions

The National Health Care Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud are in the tens of billions of dollars each year. This translates into higher healthcare costs for every taxpayer in the United States.

It’s Investigated By The FBI

Healthcare fraud is a high priority for the government, with audits being ordered for practices of all shapes and sizes.

“We seek to identify and pursue investigations against the most egregious offenders involved in health care fraud through our investigative partnerships with federal, state, and local agencies, as well as our relationships with private insurance national groups, associations, and investigative units,” states FBI.gov. “Our field offices proactively target fraud through coordinated initiatives, task forces and strike teams, and undercover operations.”

It Requires An Experienced Defense Team

Most doctors are concerned with taking care of their patients, and may not even be directly involved in the billing process for their office. Getting a notice of an audit or in-person inspection of their medical billing practices can cause a great deal of stress and worry.

The white collar crime attorneys at the Law Offices of Robert J. Degroot are skilled in preparing clients for audit and providing a strong defense for medical billing fraud charges.

Contact us to learn more.