California Healthcare Double Billing Defense Lawyer
Double billing is one of the most common billing mistakes that lead to healthcare fraud charges, along with unbundling and upcoding. Even if someone in your office made a mistake and accidentally billed twice for the same service, an accidental error can still trigger a government investigation and charges of Medicare or Medicaid fraud. It’s therefore critical to contact a lawyer right away as soon as you become aware of an investigation, formal charges, or errors in your practice that could trigger an investigation. An experienced healthcare law attorney can help you avoid charges by conducting an audit and advising you on fixing errors. If you are facing prosecution from the Department of Justice, an attorney at the Law Offices of Art Kalantar can provide a robust defense to help you avoid a conviction and consequences ranging from suspension or loss of your medical license, thousands of dollars in fines, or even jail time. Call our experienced California healthcare double-billing defense lawyer today for a free case evaluation and a shot at the best result.
Four Forms of Double Billing
Double billing is considered to be one of the leading types of Medicaid fraud. Double billing can actually occur in several different ways. Below are the most common.
- The provider bills for the same service twice. This can easily happen when the provider bills for the service individually but also as part of a larger, overall procedure, or bundle of services. When a code exists for the service as a whole, this is the correct code to use. Unbundling is a related form of fraud where the components of a procedure are separated out and billed individually to make more money. In the case of double billing, the component is billed on its own as well as part of the larger service.
- The provider bills Medicare or Medicaid (Medi-Cal) and also bills the patient or a private insurer for the same procedure, service, medication, etc.
- Two different providers bill for the same service provided to the same patient on the same date. An example of how this can happen includes a doctor providing services to nursing home residents on-site. Both the doctor and the nursing home wind up billing Medicaid for the doctor’s services. Another example would be where one medical practice conducts diagnostic tests and sends the tests to another facility to read and interpret the results. Instead of each provider billing only for their portion of work performed, either or both providers bill Medicare for the testing and the reading of the results.
- The billing department accidentally sends out the same bill twice due to a clerical error or oversight.
Sometimes the Centers for Medicare and Medicaid Services (CMS) will deny a claim as a duplicate billing, or the claim will get kicked out of the system as suspect due to some similar information on two claims, even if the claims are not entirely duplicative. This procedure can cause a delay in processing the claim or prevent reimbursement, but it can also trigger a fraud investigation.
Facing Fraud Charges for Double Billing? Call an Attorney Right Away
If you are facing allegations of Medicare or Medicaid fraud due to double billing issues, it’s essential to call an experienced healthcare fraud defense attorney immediately. Even if you haven’t been formally charged but have become aware of an investigation or asked to sit down with investigators, protecting yourself and putting yourself in the best position requires that you get a lawyer and follow that legal professional’s advice. If you wait until you have already given statements to the government, you might have damaged your case in a way that prevents you from getting an otherwise favorable result out of the situation. You have important legal rights in any government investigation or prosecution, and a healthcare fraud defense attorney can make sure those rights are protected and that you are treated fairly while raising all applicable defenses and challenges to the government’s case. It is possible to prevail against allegations of healthcare fraud, but you need the advice and representation of a skilled professional to help you win your case.
Contact the Law Offices of Art Kalantar Today
California healthcare fraud defense attorney Art Kalantar provides a strong and effective defense against charges of healthcare fraud based on double billing or other coding errors. Based in Beverly Hills, the Law Offices of Art Kalantar serves clients throughout Los Angeles and California statewide. Call our experienced California healthcare double-billing defense lawyer at 310-773-0001 today for your free case evaluation. Get the advice and assistance you need for the best outcome in your case.