Springhill Group: How to Prevent Medicare Fraud - tumblr ビジネス

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Over the years, Medicare has been proactive in its efforts to bring awareness to Medicare fraud, a national problem that costs the program millions of dollars each year. The Medicare program relies heavily on a number of sources to assist them in the detection and prevention of Medicare fraud including professionals of the healthcare industry.
Overview of Medicare Fraud
Medicare fraud generally refers to willfully and knowingly billing medical claims in an attempt to defraud the Medicare program for money. Anyone found guilty of Medicare fraud is subject to exclusion from participation in the Medicare program in addition to fines and possibly imprisonment. Most Medicare fraud occurs in these areas:
Billing for DME
Billing for physicians services
Billing for institutional services such as nursing homes, hospitals, hospice, etc.
Be Aware of Common Schemes
There are four popular Medicare fraud schemes.
Medical Equipment Never Provided The most common area of Medicare fraud is billing for Durable Medical Equipment (DME). DME refers to any medical equipment necessary for a patient’s medical or physical condition. It includes wheelchairs, hospital beds, and other equipment of that nature. The provider will bill Medicare for equipment that the patient never received. Mobility scooters have been particularly popular for Medicare fraud schemes.

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