Medical Billing Fraud Strikes Again!

Medical billing fraud can take on several forms. Usually healthcare practices are thought to be in place to help you when you are in need. People don’t usually think of healthcare facilities as crooks and liars. Unfortunately, some of them are. The state of Washington has found yet another poor example of healthcare medical billing. Star Physical Therapy was charged with medical billing fraud of over $400,000.

The owner of Star Physical Therapy, Nancy Wong was thought to be an upstanding citizen. She was even a member of the Washington State Board of Physical Therapy. Wong, proved us all wrong. She did plead guilty to medical billing fraud in June.

Apparently, Nancy Wong had convinced her medical billing staff members to charge government healthcare programs and private insurance companies for private aquatic therapy when group therapy was actually taking place. From 1999-2002, she billed the federal government for over $200,400 in fake services.

Private insurance companies also felt the wrath of her medical billing fraud. Many insurance companies do not pay for aquatic therapy. When Wong would find this out, she would charge for a different type of therapy that was covered. This is wrongful medical billing and is illegal.

Star Physical Therapy has been fined $655,000 for their wrongful medical billing. Unfortunately, this is not the only facility to produce fake claims. Each year, the country pays over one billion dollars in fraudulent claims. This hurts our citizens and our economy.

Medical billing information is very sensitive. The people who handle your coding and claims should be some of the most trusted individuals in your practice or facility. Diligent medical billing training should be implemented to teach these staff members about fraud and how it relates to the law. Medical billing fraud hurts everyone!

View all Articles by: Melissa Clark, CCS-P