Ambulance services are one of the major parts of the emergency medical services and the transportation system for those in need. However, few of the companies take advantage of the essential services by doing ambulance fraud. It occurs usually when the service provider of the ambulance knowingly submits a false claim or any claim that does not hold reality to the health care program or to the company from the services that are not being utilised or are unnecessary or may be provided at a premium level even when they are not required. Such unethical practices can lead to the significant loss of government healthcare programs, taxpayers and private insurers. Keep reading this article. We’ll take you through the further details about ambulance frauds and how the whistleblowers will help you stop it.
Following Are the Different Types of Ambulance Frauds
Billing for Non-Emergency Transportation
In the healthcare industry, ambulances are used for emergency situations which means ambulance services will be provided to the patient in critical situations and not for simple medical transportation services, like basic pick and drop services.
Upcoding
Ambulance services usually have different levels of care. Such as basic life support or advanced medical support. The upcoding takes place when the service provider of the ambulance submits a higher level of care than required.
False Documentation
The service provider of the ambulance may submit the document that supports the fraud claim such as false or fake patient reports or any fake billing service that is not provided.
Protection Law and Rewards for Whistleblowers
The major role of the whistleblower is that they expose the ambulance fraud that is accountable for that. The false claims act and Anti-kickback Statute surely provide protection and reward for whistleblowers who report fraud. Under the false claim act, the information provider can get a few percentages of the amount that has been recovered by the government of the USA as their reward for providing the information. The anti-kickback statute bans healthcare industry providers to pay kickbacks for referrals and provides protection to those who report a violation.
Reporting Ambulance Fraud
To report the ambulance fraud you can always do it through the appropriate authorities like NHS (health and human service) and (OIG), the office of inspector general can investigate healthcare fraud and abuse that surely includes ambulance fraud. If you have information for any sort of ambulance service fraud you can report it online through hotline, email etc. These legal steps will help the US government stop fraud and protect the healthcare system from damage.
Conclusion
Ambulance fraud is a serious healthcare problem that can affect the whole industry. Whistleblowers play a key role in the detection and stopping of fraud. The associations like FCA and AKS provide protection against and issue incentive for the one who detects illegal fraud and activity. If you ever come across such fraud, always report it online, and help in maintaining a sustainable healthcare system to protect the integrity of the healthcare system.