California Healthcare Lawyer for Coding Error Defense
Hospitals and other medical offices are held to very high standards when it comes to billing practices. There’s a library of billing codes used to identify various services, with sub-codes and variations depending upon who performed a given procedure, who was present, and other factors.
As with any administrative institution, mistakes can happen. Unfortunately for healthcare providers, erroneous coding may be treated as a form of fraud, punishable by civil and even criminal enforcement agencies.
If your healthcare practice is being investigated for coding errors, you need to act fast. If you do not respond to the allegations swiftly and appropriately, you could be on the hook for significant fines, penalties to your professional license, damage to your reputation, and even criminal prosecution.
Medical care providers dealing with coding error issues can rely on the Law Offices of Art Kalantar and our coding error defense team. We’ll help you conduct internal investigations, respond to audits and governmental investigations, and root out the proper cause of any billing errors that exist. We’ll fight to protect your license, your reputation, and your business. If there’s a reasonable explanation for any identified coding error, we’ll make sure to find it, protecting your rights every step of the way.
Coding Errors Can Lead to Criminal Charges
While it seems ludicrous that simple billing errors can lead to criminal liability, the laws prohibiting healthcare fraud are extremely strongly-worded. The government will investigate any coding errors they discover, and if they believe the healthcare provider is intentionally filing any false claims with Medicare, Medi-Cal, Medicaid, or other insurers, the practice may face criminal sanctions.
The government must prove intent in order to levy charges of criminal fraud. Civil penalties under the False Claims Act (FCA), however, are possible even without bad intent. Make sure you are equipped to identify, root out, and correct any possible coding errors before you get on the wrong side of a federal or state prosecutor. The coding error defense team at the Law Offices of Art Kalantar is more than equipped to help.
Common Coding Errors
When coding errors lead to overcharges, hospitals, medical offices, and other healthcare entities can face civil or criminal liability. Some of the most common forms of coding error that may be treated as fraudulent include:
- Incorrect coding – Billing for the wrong service
- Upcoding – Billing for a more expensive service
- Unbundling – Separating out related services that should be coded as a “bundle” in order to charge more in the aggregate
- Double-billing – Coding the same payer twice for a single service, or coding multiple payers for the same service
- Adding unnecessary code modifiers
- Billing for services never performed
- Coding for an unconfirmed diagnosis
At the Law Offices of Art Kalantar, our healthcare law attorney will help you identify, correct, and explain these and other coding errors before they become a liability. If you are the target of an investigation or prosecution, we’ll defend your rights and your freedom every step of the way.
Trusted Legal Advice and Experienced Representation for Coding Error Defense
Coding errors can happen for any number of reasons. The worst result is to find yourself the target of a healthcare fraud investigation. Depending upon the nature of the conduct and the parties allegedly defrauded, you could be facing charges of healthcare fraud, False Claims Act violations, Stark Law violations, and other serious misconduct.
To protect your business, your finances, and, potentially, your freedom, call an accomplished healthcare coding error defense lawyer. Your license, your practice, your assets, and your liberty may be at stake. The Law Offices of Art Kalantar and our coding error defense lawyer are ready to provide you with considered, thorough legal advice and representation for your healthcare law matters in Los Angeles and throughout Southern California.
Call 310-773-0001 at any time to request a free case evaluation with the Law Offices of Art Kalantar in Beverly Hills.