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Dr. Pearson has recently been hired into the Central City Internal Medicine Group as its fifth...

Dr. Pearson has recently been hired into the Central City Internal Medicine Group as its fifth physician. He has recently completed his residency and is eager to enter private practice. Dr. Pearson is introduced to Meredith and Dawn, two members of the billing staff for the practice. Unbeknownst to Dr. Pearson, Meredith financially assists the practice in several ways. She bills procedures by using individual codes instead of comprehensive codes, she has decided to bill Dr. Pearson’s services under the Medicare number of Dr. Craig (another Central City physician) until Dr. Pearson’s credentialing process has been completed, and habitually submits a claim more than once if she isn’t sure whether or not it has already been submitted.

Explain the types of fraudulent billing that Meredith is conducting in one paragraph?

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Answer #1

The types of fraudulent billionaires that Meredith is conducting are

Upcoding:use of individual codes instead of comprehensive codes and hence increasing the cost to the patient .Impersonation is illegal ,she conduct this by entering the services of Dr.Pearson under the Medicare number of Dr.Craig.This can be categorized as misrepresentating provider of service.This is an act of fraud or forgery done by Meredith and will be subjected to legal issues when found fault

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