Public health clinics are often overwhelmed, making it even easier to commit healthcare fraud. Patients and staff are both possible offenders, but fraud ends up hurting everyone.
From increasing healthcare costs to clinics being shut down, fraud is risky and definitely not worth it. The only solution is to reduce healthcare fraud at public health clinics to keep everyone safer and healthier.
Train medical staff to recognize potential healthcare fraud. For instance, if they’re filing paperwork and notice tests listed that weren’t performed, they should check to see if this is an error or fraud. If they notice doctors or nurses accepting bribes or under-the-table payments for services, this is fraud too.
Even though staff is usually busy, they should take a moment to verify identities whenever possible. For instance, Medicare fraud is all too prevalent due to identity theft. Sometimes, a quick check is all that’s necessary to ensure you’re dealing with the right person.
Patients Pay Close Attention
It’s also up to patients to pay close attention to what’s going on. Whether you’re paying in cash or using insurance, ensure the bill is correct and not inflated. If you receive a bill in the mail for a visit you never had, report it immediately. You may be a victim of insurance or Medicare fraud.
For seniors, ask someone you trust to look over bills to help reduce fraud. Sadly, medical professionals may take advantage of the elderly, thinking they won’t notice.
Incorporate An Anonymous Hotline
Whistleblowers are critical to reducing healthcare fraud at public health clinics. Employees can secretly report co-workers and supervisors if they suspect fraud. It’s important to have an unbiased team in place to investigate claims. Remember, anyone could be guilty. It’s not unusual for someone in accounting to blame a doctor and vice versa for billing errors. However, instead of it being an error, it’s fraud by one or the other. It’s up to the investigative team to discover which one.
Report To The Appropriate Authorities
For patients, the health clinic’s hotline might not be available. However, there are other ways to report suspected fraud and even medical identity theft. The National Health Care Anti-Fraud Association lists ways to report issues to your insurance company, state insurance fraud bureau, medicare fraud prevention organizations and more. If whistleblower complaints aren’t being addressed internally, employees must then report it to US Department of Health and Human Services Office of Inspector General. The site provides details on what types of issues to report and how to report them.
While it might seem terrifying at first, people’s lives are at risk. Public health clinic fraud can result in patients not being able to afford medical care. Or, they may learn to distrust any medical professionals, meaning they avoid getting help when necessary.
Employees are often scared to speak up for fear of losing their jobs. However, they have the power to save lives and the clinics, as they can be shut down if fraud goes on for too long.