The cost of billing fraud

ABS Inc. are going to run a series of blogs starting this week to highlight the importance of getting your billing right – first time, every time. Businesses like ABS Inc specialize in billing services and are in the best position to help you avoid the pit-falls they lay in wait.

Millions of EMS journeys are billed to health insurance companies and Medicare every year across the United States. For larger organizations they are likely employ specialized staff to undertake the work, however for smaller organizations where perhaps a minimal number of staff may be assigned billing duties as not much more than an additional duty to their routine.

In either case, the requirements are exactly the same. Billing is to be in accordance with strict requirements from a number of different agencies with Medicare being the most notable of them. If an organization fails to process their EMS claims, in accordance to the regulations, they become open to the possibility of fraud charges, significant penalty payments and even reimbursement of monies collected.

Healthcare is the currently the federal budgets largest expenditure. The huge number of claims submitted every year by an equally huge number of providers means the field of healthcare is wide open for fraud. It is estimated that the annual cost, due to healthcare fraud, to the United States government is in excess of $100bn! With the size of healthcare expenditure and estimated fraud figures, the United States government is ramping up their investigations in to fraud, looking at all types of providers.

In recent times, it was announced by the Justice Department that Columbia/HCA, the hospital giant, agreed to pay a fine of $745 million for systematically defrauding, over a period of several years, the Medicare program. Although it is not believed likely that an ambulance provider or fire department would be penalized to such a significant extent, it does indicate the government is getting serious in their drive to investigate fraud and eliminating it.

Next week, ABS Inc will highlight the common errors made by billing staff and you then begin to understand better why ABS Inc. are the sensible choice to undertake your EMS billing duties. Contact us to discuss any issues you may have and see what we have to offer to help you avoid breaching any of the many regulations in place today..