What a healthcare business can do to prevent medical fraud

Published: December 15, 2010 by bkrenek

Medical fraud is occurring at an alarming rate and is expected to cost the US healthcare system $100 billion a year.  Medical fraudsters vary in their sophistication and range from organized crime organizations to individuals preying on senior citizens.  For example, one crime syndicate stole the identities of doctors and thousands of patients to make false claims at bogus health clinics across 20 States worth $100 million.  Fraudsters working alone offer falsified free services as a tactic to acquire Medicare numbers to later bill insurers for supplies a patient never receives.

There are many things consumers can do to help prevent becoming a victim of medical fraud including not providing a Medicare number to a telephone solicitor of free services.  However, a recent article suggests that doctors, hospitals and insurers need to become more involved in protecting themselves from the damages caused by medical identity theft.

For example, medical providers should do more to verify and authenticate people who come to their offices for the first time.  A front office worker could ask the new patient to provide three forms of identification to ensure consistent names and addresses are used.  Secondly, office staff should verify the person actually lives at the address by running a credit check.   Lastly, if a potential fraud case is discovered, medical staff needs to be informed of how to contact the relevant authorities.

Protecting your business from medical fraud will not only reduce future headaches, but will protect your most valuable asset…loyal patients.