Preview

Medical Fraud Research Paper

Satisfactory Essays
Open Document
Open Document
149 Words
Grammar
Grammar
Plagiarism
Plagiarism
Writing
Writing
Score
Score
Medical Fraud Research Paper
I have been paying tax since I went to work on the first day. I am always curious where the tax money actually goes to. I have been working at a medical field for years. When I was working at a medical insurance company, I always had to review claims which submitted by doctors and patients. Most of the patients were receiving Medicare and Medicaid benefits. There was always a claim which submitted from a doctor office and turned out as a red flag of a medical fraud. This had started me to think how many claims fraud had approved for receiving payments. Besides, I had heard that my friends had purchased someone’s food stamp by cash and my neighbor was qualified 8 section with a young age with good health. Those incidents have been making me

You May Also Find These Documents Helpful

  • Good Essays

    Our project team analyzed the Fraud and Illegal Acts Case (True blood Case Studies- Case 08-9), which involves a questionable sales transaction made between Jersey Johnnie’s Surfboard, an SEC registrant, and Mr. Sinaloa, an independent sales representative of the company. As a simplified overview of the case, an external audit firm was hired on to perform a year-end audit of Jersey Johnnie’s Surfboards, Inc. Towards the end of the audit, the engagement partner notified the auditors that there could be a possibility of fraud and illegal acts made by the company. The engagement partner received a call from the company’s director of ethics and compliance, who stated that an anonymous employee of the company had called into the hotline questioning a sales transaction that seemed suspect. The sales transaction occurred at year-end on December 31, 2010, which seemed suspicious because of the timing of the transaction and effect the transaction had on the year-end figures. Specifically the employee noticed a sales invoice dated December 31, 2010 made out to a Mr. Sinaloa. This transaction was suspect for the employee because the company does not typically recognize revenue associated with products shipped to Mexico until Mr. Sinaloa presents the company with a confirmed sales order.…

    • 3236 Words
    • 13 Pages
    Good Essays
  • Satisfactory Essays

    Lisa is a candidate that has years of experience working with claims and has a good understanding of medical billing as well.…

    • 167 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    Negligence Case Study

    • 520 Words
    • 3 Pages

    Mary is cutting weeds at her home. She is unable to trim some weeds she finds, because they grew between the rocks, so she removes the protective guard on the weed trimmer and trims the weeds. There are no warnings on the weed trimmer advising against removing the guard. She hits a rock, which is thrown to the side, hitting her neighbor in the eye and causing permanent damage. What kind of tort claim does the neighbor have? Who are the possible defendants?…

    • 520 Words
    • 3 Pages
    Good Essays
  • Powerful Essays

    Case Study for Fraud

    • 996 Words
    • 4 Pages

    The amount listed is the enrollment agreement was 10,020.00 which gives a difference of :…

    • 996 Words
    • 4 Pages
    Powerful Essays
  • Good Essays

    To care about someone’s health and well-being is very important. To care about someone like a patient in this matter is more so because of medical malpractice. If a patient feels like they were neglected or mistreated and something bad came from being your care, there could be a possibility of a lawsuit. The main thing is to actually be sincere and truly care about a person. A person can tell when someone is not being sincere. To truly care about a person can give them the will to get better and to survive depending on condition. Communication is important as well when dealing in the medical field. To prevent miscommunication, make sure you are understood. If you don’t understand something or are not quit sure you heard something right, ask questions, get clarification to prevent miscommunication or any mishaps. Competence is also essential. If you are not confident in what you do and you are not knowledgeable in what you do then you will not have or gain the trust of your patients. You should always keep your skills and your education current and up to date. Charting is for documentation purposes. When documenting in charts, information should be documented as if the patient may be reading it. Documentation needs to be written legibly and accurately. I believe that all the four C’s play a very important roll in the medical field, but in my opinion I feel that caring and charting a little more important just for the simple fact that everyone wants to cared about. If you genuinely care about a person it can make a big difference. Charting is very important because the proof and documentation will always be there when you need it. You can always go back to it if you have…

    • 301 Words
    • 2 Pages
    Good Essays
  • Satisfactory Essays

    I can say your post give very interesting points referring to the fraud cost on health care. It is very interesting how much money professionals such as doctors gets by making recommendations to people to take a surgery just for the fact to pay their own debt. I do thing these type of crimes makes them worst than violent crimes because it reflect the bad use of their power in order to get what their want.…

    • 79 Words
    • 1 Page
    Satisfactory Essays
  • Good Essays

    Tax Dollars

    • 711 Words
    • 3 Pages

    Opening up an envelope on the first of the month to reveal ones monthly pay is a surprise in itself. After arriving down at the bottom of the pay stub it seems that half of the paycheck goes to the government. Where does the money go? Where do income tax dollars go? On that pay stub there are three places ones tax dollars go to and they are social security, healthcare, and defense spending.…

    • 711 Words
    • 3 Pages
    Good Essays
  • Good Essays

    I have often wondered where the majority of the tax payers money goes. It is obvious it is not going to the federal debt nor to the education system but perhaps maybe to the civilians who choose not to get an education or a job but to live off government welfare and medicaid. Ironically, these people are more than capable of providing for themselves. It is bothersome to know that my American Dream will not be completely mine, ever. There will always be a portion that will go to a woman or a man who is, for lack of a better word,…

    • 637 Words
    • 3 Pages
    Good Essays
  • Good Essays

    Medical Identity Theft

    • 638 Words
    • 3 Pages

    Medical identity theft is rapidly growing. Medical identity theft is when someone takes your medical identity and uses it to get medical care and/or financial gain. There is ways to help protect yourself from this crime you need to check your medical information. If you find errors you need to file a police report and give copies of the police report to the appropriate people. You also have to get the errors you find in your medical records corrected, which can be hard to do because your information could be in multiple locations.…

    • 638 Words
    • 3 Pages
    Good Essays
  • Better Essays

    Medicaid Fraud

    • 1539 Words
    • 7 Pages

    Medicaid fraud comes in many forms. A provider who bills Medicaid for services that he or she does not provide is committing fraud. Overstating the level of care provided to patients and altering patient records to conceal the deception is fraud. Recipients also commit fraud by failing to report or misrepresenting income, household members, residence, or private health insurance. Facilities have also been known to commit Medicaid fraud through false billing. The Medicare and Medicaid fraud and abuse statute provides that an individual who knowingly and willfully offers, pays, solicits, or receives any remuneration in exchange for referring an individual for the furnishing of any item or service (or for the purchasing, leasing, ordering, or recommending of any good, facility, item, or service) paid for in whole or in part by Medicare or a state health care program (i.e., Medicaid) shall be guilty of a felony; this is known as the “anti-kickback” statute (Mackelvie, 2004). Medicaid fraud affects taxpayers, recipients, and health care organizations. Measures to reduce Medicaid fraud are necessary.…

    • 1539 Words
    • 7 Pages
    Better Essays
  • Better Essays

    Modern Healthcare. (2010, June 28). The new fraud offensive; It 's time to sto losing billions to fraud each year and redirect those dollars. . United States of America. Retrieved from www.lexisnexis.com/hottopics/Inacademic…

    • 1927 Words
    • 8 Pages
    Better Essays
  • Good Essays

    Healthcare Fraud and Abuse

    • 1052 Words
    • 5 Pages

    As we head into the next four years under the Obama administration, many Americans are hearing more and more about healthcare reform and what needs to be done to fix the ailing healthcare system. Part of the dramatic increase in healthcare costs is due to Medicare fraud abuse. Healthcare fraud is defined as making false statements or representations of material facts in order to obtain benefits or payment. Healthcare abuse is defined as practices involving the overuse or misuse of services, either accidentally or intentionally, for various reasons that results in overpayment. These acts may be committed by an individual person or an entity. Fraud and abuse exposes a person, provider, or entity to criminal and civil liability (CMS, 2012). Healthcare fraud and abuse costs taxpayers billions of dollars each year, causing an increased strain on state and federal budgets, and puts a beneficiary’s health and welfare at risk. The HIM professional plays an important role in controlling this type of fraud and abuse.…

    • 1052 Words
    • 5 Pages
    Good Essays
  • Better Essays

    Healthcare Fraud

    • 1833 Words
    • 8 Pages

    Fraud is a serious crime that should concern all parties of the U.S. health care system and is a costly reality that the government cannot overlook. While not all fraud can be prevented, by learning about the many different types of fraud, patients can be educated on how to protect themselves from fraud. If we use government programs to inform the public that they can be targeted, the dollar amount for these cases for fraud can be reduced. An informed public and a properly funded FBI will go a long ways in the overall crackdown of health care fraud.…

    • 1833 Words
    • 8 Pages
    Better Essays
  • Powerful Essays

    Healthcare Fraud and Abuse

    • 3859 Words
    • 16 Pages

    Cited: Barrett, M.D., Stephen. "Insurance Fraud and Abuse: A Very Serious Problem." Quackwatch.com. Quatchwatch, n.d. Web. 1 Nov. 2011.…

    • 3859 Words
    • 16 Pages
    Powerful Essays
  • Good Essays

    Medicare Fraud

    • 335 Words
    • 2 Pages

    King, G., Nielsen. R., Coberley, C., Pope, J. E. / & Wells, A. (2011). Avoiding Randomization Failure in Program Evaluation, with application to Medicare Health Support Program. Population Health Management, 14S-11-s-22, doi: 10.1089/pop. 2010.0074.…

    • 335 Words
    • 2 Pages
    Good Essays