subject: How to avoid Insurance billing frauds [print this page] How to avoid Insurance billing frauds
Insurance is a kind of financial protection against occurrences of unpredictable events that might lead to physical and financial loss. In the process of claiming insurance, the insured person bills a certain amount to the insurer on the basis of the financial loss or expenses incurred by him.
Insurance billing experts predict that each year millions of dollars are lost because of deceptive medical and insurance practices. The fraudulent practices include claiming insurance for services that have not been availed by the insured person, billing for services that do not come within the perimeters of the insurance policy and also distributing insurance services in other than the prescribed activities. These criminal acts can be conducted by both the insurer as well as the beneficiary.
Governments worldwide are coming up with insurance billing laws to counter felony committed by the various organizations and individuals. These laws provide protection against insurance billing fraud and have been developed with the goal of providing a common insurance billing system to prevent any kind of errors and fraud.
There are a number of simple steps that can be taken to prevent insurance billing fraud. The first step should be taken by the insurance company in screening employees who serve as insurance billers. A background check as well as year round screening of the billing certificates of the candidate will help in identifying any kind of discrepancy.
There are acts like HIPPA act which is a central legislation designed to protect a candidate's personal information and privacy. Working in harmony with this act will prevent fraud to some extent. The insurance legislation insures that the personal information of the patient or the insured candidate is kept secured so that an impersonate individual does not take advantage of the leaked information and claim insurance. For this the insurance organization can ensure that the computers are password secured and can not be accessed easily without proper identification. The other thing that can be done to prevent insurance billing fraud is to get a confidentiality statement from all those employees that have access to the private information's of the candidates.
On the part of the insured person, care should be taken that he does not divulge his personal information to strangers. The candidate should keep the organization up dated with his current address and contact number so that important documents do not fall in to the hands of the wrong person.
All the above factors will help in preventing insurance billing fraud and ensure fast and fraudulent free reimbursement of insurance money to the respective policy holders.
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