Name the types of fraudulent billing.
http://payerfusion.com/ceos-blog/medical-billing-fraud-abuse/
Since this is not my area of expertise, I searched Google under the key words "fraudulent billing types" to get these possible sources:
https://www.google.com/search?client=safari&rls=en&q=fraudulent+billing+types&ie=UTF-8&oe=UTF-8&gws_rd=ssl
In the future, you can find the information you desire more quickly, if you use appropriate key words to do your own search. Also see http://hanlib.sou.edu/searchtools/.
There are several types of fraudulent billing practices that individuals or organizations may engage in. Here are some common types:
1. Phantom Billing: This involves billing for services or products that were never provided. It could include billing for fictitious patients, procedures or supplies.
2. Upcoding: This happens when a provider intentionally submits a bill with a higher code or level of service than was actually performed. For example, billing for a more complex medical procedure when a simpler one was actually performed.
3. Unbundling: This involves billing separately for components of a service that should be combined into a single charge. For example, instead of billing for a bundled lab test that includes multiple tests, billing for each individual test separately to increase revenue.
4. Double Billing: This occurs when a provider submits multiple claims for the same service to different payers or submits the same claim multiple times.
5. Balance Billing: This happens when a provider bills a patient for the difference between their charges and what the insurance company has paid, even if the insurance company's payment is considered full payment.
To identify cases of fraudulent billing, individuals or organizations may employ various techniques such as conducting audits, reviewing billing records, analyzing patterns of billing, comparing charges to industry standards, and relying on whistleblowers or tips from patients or employees. It's important to note that only trained professionals or investigators should engage in these activities to avoid unnecessary legal or ethical issues.