UB-04 Software Discusses Medical Billing Fraud

RICHMOND, VA, October 05, 2011 (Press-News.org) Are you being charged accurately for medical care? Fraudulent medical billing forms cost private individuals and insurance companies thousands of dollars each year. On September 15 in Jackson, MS a not guilty plea was entered in court by a former cancer clinic office manager, according to a story issued by the Associated Press*. She is facing charges of healthcare fraud that stem from allegations that include giving patients cheaper drugs than they were billed for and not billing properly for chemotherapy treatments.

Prosecutors allege that three women were involved in a fraud scheme where Medicare and Medicaid were billed for more chemotherapy drugs and needles than the patients were actually given at Rose Cancer Center, located in Summit, MS. The cancer center has been under intense scrutiny since early 2011 when 11 of their patients were treated at a local hospital for the same type of bacterial infection. The center was closed by the Mississippi Health Department on July 20, 2011 because their infection control practices were deemed unsafe. Former patients are still being tested for hepatitis and HIV, but no such infections have been found.

Court records include a detailed chart that shows serious discrepancies in the amount of pharmaceutical drugs that the company allegedly purchased from their drug suppliers and the amount of drugs that Medicaid and Medicare were billed for. The clinic allegedly purchased 45,100 milligrams of the cancer drug Erbitux, but sent out bills to be reimbursed for 142,200 milligrams of the drug. Other drugs showed similar discrepancies in the amount actually purchased and the amount Rose Cancer Center billed Medicaid and Medicare for.

The owner of Rose Cancer Center is originally from India and has become a naturalized citizen of the United States. She is being held without bond because she is considered a flight risk. Her frequent travel overseas as well as her wealth make her likely to leave the country, so she will not be released until after her trial. Medical billing fraud is not new, and cases often happen on a smaller scale than the case against Rose Cancer Center. Smaller fraud cases may go undetected by authorities, so patients have to advocate for themselves.

The best defense for individuals against medical fraud is to be aware of the names and amounts of drugs you are actually taking and check your medical bills carefully to make sure the drug names and amounts match your records. It is also helpful to have a working knowledge of medical billing procedures so you can avoid companies taking advantage of you. Find more information about medical billing procedures visit www.ub04software.com.

*Refer to AP story here: http://www.chron.com/news/article/Ex-clinic-worker-pleads-not-guilty- ... 171724.php

UB-04 Software has developed health insurance form filling programs to help doctors save time and money. Please learn more at http://www.ub-04software.com/index.php.