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It is better to get all of the facts on operating a home health care business the legal way before opening the doors. These procedures and practices can keep your doors opened forever, or close them with stiff penalties.

Patient’s trust their health care providers. They trust that they will take care of them. Moreover, they trust that they will bill their insurance company correctly and that they will not give unnecessary treatment for financial gain. You see, fraud brings about an increase in health care costs, and many cannot afford to feed the greedy agency’s dishonest appetite. For instance, patients who have private health insurance often have lifetime caps or other limits on benefits under their policies. So every time a false claim is paid in a patient’s name, the dollar amount counts toward that patient’s lifetime or other limits. This means that when a patient legitimately needs his or her insurance benefits the most, they may have already been exhausted.

Although the majority of health care fraud is committed by a very small minority of dishonest health care providers, it’s non-the-less fraud. For home health care, fraud may look like the descriptions listed below:

.Bill for services that were never rendered
.Bill for more expensive services or procedures than were actually provided or performed
.Accepting kickbacks for patient referrals

Health care providers that engage in the above are subjected to stiff penalties. Congress, through the Health Insurance Portability and Accountability Act of 1996 (HIPAA), specifically established health care fraud as a federal criminal offense, with the basic crime carrying a federal prison term of up to 10 years in addition to significant financial penalties.

Educate your team on the serious effects should guidelines not be adhered to. Make sure that the patient is receiving proper treatment according to the doctor’s order, and that billing is being submitted accordingly.