Professional Billers and Coders have a moral, legal, and ethical responsibility to submit claims properly. It is vital that students understand the high stakes. To help you get a feel for the scope of the issue of fraud explore this site.
Explore the different aspects to billing and coding fraud.
Include ALL the following aspects in the discussion:
- Choose two examples of fraud that interest you
- Summarize the case
- Discuss the role the coder played in the fraud
- Consider what your response would/should be if you were asked to be a part of the fraud
- Discuss if ignorance of the billing/coding rules provides sufficient legal protection?