Every day medical facilities are buzzing with people entering and exiting the premises. Treatments greatly vary and now, health care coverage does too. This may cause problems for local accounts receivable management teams, but workers need to be extremely careful about making costly mistakes.
Medical errors on a patient's bill, reimbursements from Medicare and Medicaid Services or typos may cause a practice to be audited for suspicious activity or flagged for allegedly committing health care fraud on purpose. A report from Syracuse University's Transactional Records Access Clearinghouse found that in 2013, there were 377 incidents of health care fraud.
This figure may not sound high among the hundreds of practices in the United States, but since the Department of Justice issued a statute on health care fraud, this 3 percent increase is the highest the agency has ever seen. Investigations to get to the bottom of fraud were led by the Department of Health and Human Services and the FBI — any practice that goes through this type of ordeal is likely costing itself hundreds of dollars from a loss of productivity.
To break it down into how common the situation was, TRAC researchers wrote that "there were 1.2 prosecutions under the lead charge of 18 USC 1347 for every million people in the United States."
As the Affordable Care Act rolls out this year, it is likely that many medical billing professionals could be more prone to mistakes in their paperwork. This is why it is important to pay special attention to every transaction, ensuring that the final bill is covered by the patient's health care coverage.