Billing for Services Not Provided

Florida Defense Attorney for Medical Providers Accused of Billing for Services Not Provided

Billing errors can occur in any number of ways. Insurance companies, Medicare and Medicaid become concerned when a pattern of discrepancies emerges during an audit or review.

During a Medicaid or Medicare audit, an investigator will review a wide range of clinic records to determine if the clinic or office was properly staffed and resourced to provide the services it said it provided. Investigators may then interview patients to determine if they received the services the clinic said were provided. They will look for false records and false claims.

An insurance company may analyze the bills of a large number of physicians in the same state looking to see if one provider is using a CPT code far in excess of other physicians. This is another signal of healthcare fraud and false claims.

The Law Offices of Mark L. Horwitz defends doctors and clinics, dermatologists, chiropractors, home health care providers and durable medical equipment suppliers charged with health care fraud and conspiracy to commit fraud.

If your office is being audited for billing problems or you are facing fraud charges for billing for services not provided, contact our Orlando law office today to learn how we can help.

Defense in Cases of Error and Intentional Misrepresentation

• Incorrect CPT codes could create an ongoing pattern of problems and can occur without any malicious intent
• Improper unbundling of services may be an issue that involves differing interpretations of billing codes
• Elderly patients may not accurately recall which services were provided and so can be unreliable sources of information when determining if a claim was false
• A service may have been provided that was not eligible for coverage and so it was improperly or mistakenly reclassified

A charge of fraud involving billing for services not provided can also occur when a health care provider sees a group of residents at a nursing home or group home. They may see every resident, billing some for whom the medical service was not needed or not provided. Group visits can trigger a false claims investigation.

While we cannot guarantee any particular outcome, your chances of avoiding criminal charges are much better when you involve a defense attorney early on in your case. If we cannot prevent criminal indictments, we are prepared to vigorously defend our clients in court.

Contact a Health care Billing Fraud Defense Lawyer

Our attorneys work to help clients avoid criminal charges, legal complications and heavy penalties. To schedule a confidential consultation to discuss your case, contact the Law Offices of Mark L. Horwitz.