Pat Diaz and Associates investigation experts zero in on medical fraud in areas such as…
- Asset Misappropriation
- Corruption
- Fraudulent Statements
- Embezzlement
- Theft
There is always a hidden financial trail with medical fraud. And we know which stones to turn over you discover medical fraud irregularities. Our financial investigators perform a specific analysis of digital and paper documentations to reveal where the holes are and who dug them. Interviews of employees and non-employees to pinpoint medical fraud maybe conducted to verify our suspensions and build a solid case of medical fraud evidence. We will locate and confirm independent information sources to resolve the problem. We can also implement an undercover workplace investigation if warranted.
False medical claims
Health care scams cost Americans billions of dollars each year. Taxpayer-funded programs such as Medicare, Medicaid and others are among the biggest victims. This makes health-care fraud one of America’s largest taxpayer ripoffs. Organized crime rings hatch many schemes. Hospital chains, individual employees and even patients can be involved — as victims or perpetrators.<span class="su-quote-cite"><a href="https://www.fbi.gov/about-us/investigate/white_collar/health-care-fraud" target="_blank">Health Care Fraud - The FBI</a></span>
- Billing for services not rendered.
- Billing for a non-covered service as a covered service.
- Misrepresenting dates of service.
- Misrepresenting locations of service.
- Misrepresenting provider of service.
- Waiving of deductibles and/or co-payments.
- Incorrect reporting of diagnoses or procedures (includes unbundling).
- Over utilization of services.
- Corruption (kickbacks and bribery).
- False or unnecessary issuance of prescription drugs.
DO NO HARM' ISN'T THEIR MOTTO January/February 2013 - by Charles Piper, CFE, CRT © 2016 Association of Certified Fraud Examiners, Inc
Rooting out health care fraud is central to the well-being of both our citizens and the overall economy
Health care fraud costs the country tens of billions of dollars a year. It’s a rising threat, with national health care expenditures estimated to exceed $3 trillion in 2014 and spending continuing to outpace inflation. <span class="su-quote-cite"><a href="http://www.insurancefraud.org/scam-alerts-false-medical-claims.htm#.VwWQlfkrKuc" target="_blank">the Coalition Against Insurance Fraud</a></span>