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3 ways to avoid charges for unintentional Medicare fraud

As a new physician eager to maximize revenue, you need to make sure you do not unintentionally stumble into Medicare fraud through sloppy practices or mismanagement. Even though you do not have any intentions to commit fraud, sometimes you can get in trouble by accident. There are several scenarios where you can be charged with Medicare fraud even when you think you provided a legitimate service and billed everything correctly.

Do not rely solely on your good intentions to stay out of trouble. Here are some best practices to avoid unintentionally defrauding the government.

1. Supervise closely

Fraud can occur easily if you are not in close proximity to or in communication with other providers. While supervision requirements vary, it is crucial to know that it is not simply a general term. Look over what specific supervisory role you have over providers such as physical therapists. Depending on your situation, you might need to be readily available by phone or even in the same room as the provider.

2. Manage billing clerks

While you want to rely on staff to streamline your processes, it can sometimes lead to sloppy management. Your billing clerks might assume you performed particular services when you did not. If you did not provide a service, even if you were supposed to, this could be a fraudulent billing practice. Make sure to closely manage and communicate with your billing clerks about any services you do or do not provide.

3. Keep track of your licenses

Billing with an expired license can lead to health care fraud charges. Any services provided without an active license can be seen as fraudulent. Make sure you and your staff update your licenses promptly. Any lapse can lead to conviction or a loss of your license.

Keep in mind that even if your staff commits unintentional fraud, you could ultimately be held responsible. If you have been questioned about or charged with Medicare fraud, be sure to talk to a criminal defense attorney before you do anything else.

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