Medical malpractice is not always the result of a botched operation. It may be the result of medical billing abuse.

“While most people think of medical malpractice as a failed operation or a misdiagnosed illness, there is another form of medical malpractice beginning to rear its head – financial medical malpractice. This is the consistent over billing by doctors for treating seniors on Medicare. In fact, a recent study by the Center for Public Integrity (CPI) discovered that physicians have overbilled to the tune of $11 billion over the last ten years,” stated Charlie Donahue, a Manchester medical malpractice lawyer with offices in Keene, New Hampshire.

There are multiple sides to every story — the doctor’s side and Medicare’s billing department’s side, and then there’s the truth. Many medical groups suggest the increase in billing is due to the fact that treating the elderly has grown more complex, and takes more time. While modern technology assists physicians diagnose their senior patients, the cost of that technology can be high.

“Some doctors have indicated they have actually undercharged for years and are just now submitting more accurate bills that cover their time and the use of expensive technology. Medical billing codes are set up in such a way to reflect making higher payments for procedures that take more effort and time,” added Donahue. Whatever the truth may be in this scenario, the CPI has shown Medicare claims between 2001 and 2010 show physicians consistently using the more expensive billing codes, and ignoring the less expensive ones.

This particular practice is referred to as ‘upcoding,’ and it has become much more prevalent within the last ten years. Additionally, government audits are showing that doctors are making it a practice to bill out for more extensive and costly services than they are actually delivering.

“Does this have to do with e-health records? Some think so, as creating a patient profile with extensive details is as easy as 1-2-3 on a computer. While this may seem like an odd concern for those that use the health system, the reality here is that fraud like this harms everyone. Billing for services not delivered may also result in medical malpractice of the usual kind, when a patient is harmed in the process of putting money before patient care. Where is a good whistleblower when you need one?” asked Donahue.

It is time to deal with this situation.

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