Fraud in your healthcare involves using the health care system for financial gain. It can be committed by dishonest providers, pharmacies, medical equipment companies and other related entities.
Some common types of fraud include misrepresentation of services, billing for services not performed, altering claim forms for higher payments and providing unnecessary medical services to patients. Below, we’ll take a look at smart ways to reduce fraud in your healthcare business.
Speak to your employees
The first thing you should do is speak to your employees so that you can encourage them to pay attention to their explanations of benefits and billing statements to make sure the listed services are accurate. Patients often won’t read these documents properly.
Member ID cards, explanations of benefits and other health plan correspondence should be secured. No unauthorized people should be able to access them.
Data stored in electronic healthcare records must be structured using consistent medical terminology and semantics. It must also be readily accessible to users.
Make card technology do the enforcement
Chip card technology can help to solve the dilemma faced by healthcare professionals. When electronic parameters flag a risk of fraud, the transaction can be cancelled.
Accounting controls due to healthcare fraud
In your efforts to reduce fraud in your healthcare business, one of the smartest things you can focus on is accounting controls. The infographic below will give you more stats and figures to back this up.
Credit to University of Alabama Birmingham