• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

LNC Krug

Legal Nurse Consultant Sandra Krug

  • Home
  • About Us
    • About Sandra
  • Shop
  • Services
    • Assess Medical Records & Analyze the Case
    • Compliance and HIPPA
    • Criminal
    • Elder Law
    • Fraud and Abuse
    • Health, Illness or Injury-related Legal action
    • Negligence
    • Nursing Home Abuse
    • Nursing Malpractice
    • Personal Injury
    • Product Liability
    • Risk Management
    • Toxic Tort and Environment
    • Worker’s Compensation and Workplace Injury
    • Other Health, Illness or Injury Cases
    • Why Engage a Legal Nurse Consultant (LNC)?
  • Newsletter
  • Contact Us
  • Blog
    • Blogs About EMR
You are here: Home / Services Overview / Fraud and Abuse

Fraud and Abuse

Health care fraud and abuse is a national problem, that takes many forms, and affects all of us either directly or indirectly.

It is the deliberate falsification, dishonesty, or planned act of deception for the purpose of getting higher reimbursements.

Health care fraud costs the country tens of billions of dollars a year. Some patients are also harmed in furtherance of these schemes.

 

Some common types of fraud include:

Providers

  • Allowing untrained or uncertified subordinates to provide medical treatments
  • Billing for covered services when actual services provided were not covered
  • Billing for equipment and products not ordered or distributed
  • Billing for services not provided
  • Carrying out unnecessary teeth removals on adults and children
  • Charging for a more intricate service than what was provided
  • Duplicate submission of claims for the same service
  • Misrepresentation of provided services
  • Ordering unnecessary lab tests

Members

  • Adding someone who is not eligible for coverage to a policy
  • Failing to remove someone who is no longer eligible from a policy
  • Using a member ID card that does not belong to that person
  • Visiting several doctors to obtain multiple prescriptions

One of the most effective ways Legal Nurse Consultants determine if insurance information is being used deceptively, is to review the explanation of benefits forms sent to patients from their insurance company.

These forms list the services and supplies supposedly provided to patients from medical providers. If any billings are suspect, we will immediately contact the insurance company.

 

Our nursing knowledge, clinical experience & integrity are invaluable assets for your team & your cases…
Krug Consulting
Click here to Contact Us via email or Call (844)-LNC-KRUG (844)-562-5784

Search Our Site

Connect with me…

  • Email
  • Facebook
  • LinkedIn

Recent Posts

  • Autism (ASD): The Most Eye-opening Fundamentals to Know
  • Symptoms of COVID-19 – important to know it all
  • Social Distancing, isolation, quarantine – the reason why is to be protected

Categories

Toll Free +(844) 562-5784

Legal

View Legal Disclosures

Meet Sandra

I have over 23 years of clinical healthcare experience and education on a wide variety of healthcare and medical-legal specialties. Read More…

Connect with me…

  • Email
  • Facebook
  • LinkedIn

Copyright © 2017–2023 · Krug Consulting · All Rights Reserved
5910 Post Blvd. Unit 110296 · Bradenton · FL 34211 ·(844) LNC-KRUG