Charging for unnecessary or not performed medical services
Billing for fraudulent providers, duplicate billing and billing for unnecessary services are the most common type of healthcare frauds, costing American citizens and commercial insurers millions of dollars every year.
Charging for more services than needed is usually used in the case of hypochondriac patients. They are bombarded with tests and exams that go on forever or at least until the coverages can be used, with the alcohol and drug rehabilitation facilities overusing these services the most, according to the U.S. National Survey on Drug Use and Health.
For example, a provider in Detroit was caught overbilling patients for services not rendered, namely nerve-block injections, which cost Medicare around $25 million, reported the Department of Justice. Another medical provider overcharged Medicare private payers for unnecessary services such as stents, catheterizations, tests, and unrequired coronary artery bypass surgeries. The fraud cost Medicare $29 million. And the examples could go on…
