See something, say something
Read Time: 7 mins
Written By:
Renee Flasher, Ph.D., CFE, CPA, CMA
Mabel Filldenshod, 67, a recently retired executive, is playing golf with some buddies. She’s on the fourth hole when she begins to have heart palpitations. She plays for another 15 minutes, but her heart is still thumping fast. So, one of her friends drives her to Filldenshod’s doctor. Dr. Flornusher runs an EKG, doesn’t find any problems with Filldenshod’s heart and proclaims her to be in fine health. Good news for Filldenshod but even better news for Dr. Flornusher.
After Filldenshod leaves, Dr. Flornusher bills Medicare for the EKG but also reports the visit as an appointment for a heart patient, which Filldenshod isn’t, but brings in more money for the doctor. That’s called upcoding, and it’s illegal.
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Read Time: 7 mins
Written By:
Renee Flasher, Ph.D., CFE, CPA, CMA
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