# Medicare Fraud



## eman00

Has anybody heard about the FBI raiding and arresting of 107 people across the US for medicare fraud? I read in one of the articles that Alpha Ambulance based in Los Angeles, CA was one of the ambulance companies that was raided, including four ambulance companies in Houston, TX.


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## STXmedic

Ha! Beat you to it!


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## mycrofft

http://usnews.msnbc.msn.com/_news/2...gest-ever-medicare-fraud-totaling-450-million


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## bstone

I read about it today. The article mentioned ambulance services fraudulently billing Medicare for transports that did not require an ambulance.


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## jjesusfreak01

bstone said:


> I read about it today. The article mentioned ambulance services fraudulently billing Medicare for transports that did not require an ambulance.



In their opinion...

This is the problem. At least where I live, ambulance transports require a physician or a nurse to sign off on it as medically necessary. It should never be the responsibility of an EMT Basic or a dispatcher with no medical training to determine whether a patient should be transported by stretcher. I like to think i'm good at it, but realistically, there are thousands of reasons that someone would need stretcher transport, and if a doctor says they do, it shouldn't be on me or my company for billing for that transport.


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## mycrofft

Person on the scene and the pt need to decide on service and transport, but they can't decide how to bill it.


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## Veneficus

bstone said:


> I read about it today. The article mentioned ambulance services fraudulently billing Medicare for transports that did not require an ambulance.



that describes every private ambulance company i ever worked for, even the most reputable agencies.


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## PotashRLS

jjesusfreak01 said:


> In their opinion...
> 
> This is the problem. At least where I live, ambulance transports require a physician or a nurse to sign off on it as medically necessary. It should never be the responsibility of an EMT Basic or a dispatcher with no medical training to determine whether a patient should be transported by stretcher. I like to think i'm good at it, but realistically, there are thousands of reasons that someone would need stretcher transport, and if a doctor says they do, it shouldn't be on me or my company for billing for that transport.



Spot on.

All our nursing home transports are initiated by a 911 call from the nursing home.  They almost always have a prescription for transport by ambulance.  The medical necessity should fall on the nursing home and the patient's physician and not the transporting agency.  As a 911 provider, we have no choice but to respond and transport (most residents can no longer make decisions for themselves).


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## mycrofft

I often wonder (well, not too often) how well ambulance and other "smaller" agencies understand billing to Medicare etc.
A case manager may make a decision whether to pay your , ask for supporting materials, or deny you, but if they mistakenly pay you and an audit shows you actually did not have grounds for payment, they aren't going after the _case manager's_ pay to reimburse it...

What percent of these cases will turn out to be screwups by ambulance billing which found a formula that seemed to guarantee payment and started rubber-stamping it?


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## PotashRLS

mycrofft said:


> I often wonder (well, not too often) how well ambulance and other "smaller" agencies understand billing to Medicare etc.
> A case manager may make a decision whether to pay your , ask for supporting materials, or deny you, but if they mistakenly pay you and an audit shows you actually did not have grounds for payment, they aren't going after the _case manager's_ pay to reimburse it...
> 
> What percent of these cases will turn out to be screwups by ambulance billing which found a formula that seemed to guarantee payment and started rubber-stamping it?



That is why you have a professional billing company do your ambulance billing.  They are fully insured and liable for their services.


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## Veneficus

mycrofft said:


> I often wonder (well, not too often) how well ambulance and other "smaller" agencies understand billing to Medicare etc.
> A case manager may make a decision whether to pay your , ask for supporting materials, or deny you, but if they mistakenly pay you and an audit shows you actually did not have grounds for payment, they aren't going after the _case manager's_ pay to reimburse it...
> 
> What percent of these cases will turn out to be screwups by ambulance billing which found a formula that seemed to guarantee payment and started rubber-stamping it?



I have seen the fraud perpetuated by both ends for a number of reasons. Some actually admirable. 

(recently I met a doctor who was laughing at the idea of "Robin hood" stating everybody robs from the rich, it is pointless to rob from the poor)

Anyone who has been at this game for any length of time knows the problem is largely the system. 

It costs a crazy amount of money to do IFT with ambulances requiring emergency persons and equipment of a 911 vehicle while getting paid less than 1/2.

But there a few alternatives. Wheel chair transport gets even less. 

I have seen doctors sign medical necessity forms (with the most bogus reasons) simply because if they didn't nobody would help the patient. 

I have been coached even threatened to use "magic words" by every private employer I have ever worked for. I was even threatened to a point where I was making up information I didn't have. I later learned this same company asked my partner to rewrite some of my run reports after I had left the company.

My most notious story is from a vagrant patient who didn't even have ID, much less a permanant residence we picked up 911 for suicide.

I had no address and the company threatened to withold my pay, write nasty things in my file, etc. until I just broke down and made up an address to placate them. (It was the building we picked her up in front of) 

When I brought it to the attention of the the VP, even he seemed to think I should somehow have gotten a billing address on the homeless person. Suggesting I should go to the hospital and ask the patient again.

There are probably more than a few organizations in EMS that barely scrape by. Still more with such cashflow issues that unless they get a rubber stamp on a billing claim will be in serious trouble.

I am sure there might even be a small handful of outfits that are purposefully frauding the system. (Most of which I would guess have some kind of organizational links with a history of such practices in retirement funds and union dues because of the complexity of the crimes)

But the problem isn't going to be solved simply by hunting down the few malicious frauds.

It will be solved by mandates and reimbursement schedules that don't make it impossible for a reputable company to make a buck on time without having to resort to gaming the system.


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## Amberlamps916

My company just held a meeting over the "Magic words" for Medicare on the run tickets, complete with angry Armenian operations manager slamming his fist on the table, signaling that he means business. What a crock.


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## jjesusfreak01

Veneficus said:


> I have seen doctors sign medical necessity forms (with the most bogus reasons) simply because if they didn't nobody would help the patient.



Wheelchair transports need to be covered by insurance companies. Period.


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## mycrofft

Fix the system? But it's so much easier to scapegoat, point the finger, call in the villagers and go get them.






Use the Russian Quid Prop Quo: "If you pretend to pay me, I'll pretend to work"


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## Medic2409

Unfortunately we are in a catch-22.  We are expected to treat and transport everyone without caring whether or not they can pay.  At the same time, the government doesn't want to pay for the times we transport someone who doesn't need an ambulance.

It should be pretty simple...someone calls for an ambulance and we transport them, after which we get paid.


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## Veneficus

Medic2409 said:


> It should be pretty simple...someone calls for an ambulance and we transport them, after which we get paid.



You are such a dreamer...

But there is also the issue of the minimum standard of care keeps going up, which means more expensive equipment, more training, etc. but the reimbursement doesn't go up. 

I also still maintain IFT should be a seperate billing schedule, equipment, and staffing requirements than a 911 ambulance. (much less for all of these things)


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## mycrofft

It would be interesting to see how many trips an ambulance needs to make (average actual pay received per trip versus amortization, insurance, fuel, and upkeep) before it is paid off and starts making money? (This is ignoring personnel costs, costs of housing and controlling the ambulances, licensing, etc.).

Possibly this is a field where, unless you cheat or cheapskate it, you can't make enough money. If so, we need to stop paying and permitting lowball artists and make primary transport and response civil service, the true and original reason for creating a civil service in the first place.


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## Medic2409

Perhaps 911 EMS should be a City or County level Public Service, leaving the IFT's to private contractors.

Question:  In how many other industries does the provider have to settle for charging less than cost?  Do Plumbers, Electricians, or Mechanics, just to name a few, have to settle for charging less than the cost of doing business?  

So, is EMS a Business or a Public Service?  How can any Business be expected to survive if it is only able to recoup a percentage of it's billable costs?


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## Veneficus

Medic2409 said:


> Perhaps 911 EMS should be a City or County level Public Service, leaving the IFT's to private contractors.
> 
> Question:  In how many other industries does the provider have to settle for charging less than cost?  Do Plumbers, Electricians, or Mechanics, just to name a few, have to settle for charging less than the cost of doing business?
> 
> So, is EMS a Business or a Public Service?  How can any Business be expected to survive if it is only able to recoup a percentage of it's billable costs?



Fine questions.


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## mycrofft

Dunno, lets ask AMTRAK passenger, or US Postal Service, or anyone accepting or forced to accept MEDICARE or Medicaid. Or any small business  trying to out-comnpete Walmart


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## Vladimir

*Oh My Gosh dude!!!*

So I saw at least one of you say that you guys committed fraud!!! WOW... The thing with this type of fraud is that it becomes a bigger crime with the intent, that you are currently admitting. The truth is that the thing that makes an ambulance service so prohibitively expensive is the 24/7 component, but even this can be mitigated by decent management. Medicare pays a decent amount, (not a huge amount, but decent) for transports. Privates are just that, private! So that means the company may have little money after the owner attempts to probably squeeze every penny out of the company at the end of the month.

SO with all that being said... STOP COMMITTING FRAUD!!!
You lie on a run sheet, you make some information up, you use "SPECIAL WORDS", you are rewriting for your employer, you are committing fraud! Is your job right now going to be your career? Is Ivan, Igor, Sebatian, Vladimir, or whatever going to have your back dude? no they will disavow you! This is a serious crime, so please do not commit it, you could potentially go to prison for it, geuss who investigates medicare fraud!!! The FBI!

So dont be a fool... stay in school.. lol


Your friendly neighborhood commentator,
Vladh34r:


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## TatuICU

bstone said:


> I read about it today. The article mentioned ambulance services fraudulently billing Medicare for transports that did not require an ambulance.



To be fair, about 85% of calls do not require an ambulance.  But we're legally obligated to take these gomers to the hospital wasting every everyone's time and money.  So until they change the laws, I say companies have the right to bill the living crap out of everyone, including medicare.


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## TatuICU

Addrobo87 said:


> My company just held a meeting over the "Magic words" for Medicare on the run tickets, complete with angry Armenian operations manager slamming his fist on the table, signaling that he means business. What a crock.



L-M-A-O!!!! Are you for real? How in the world did you or anyone else keep a straight face??? Or did you?


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## Vladimir

*Report it*

:excl::excl::excl:What company do you work for that you were told to use magic words?
I would say, REPORT that to both medicare, cms, and your local fbi office. if you are in los angeles, youll be probably assisting in an ongoing investigation.:excl:


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## Veneficus

Vladimir said:


> :excl::excl::excl:What company do you work for that you were told to use magic words?
> I would say, REPORT that to both medicare, cms, and your local fbi office. if you are in los angeles, youll be probably assisting in an ongoing investigation.:excl:



Are you kidding?

Even hospitals buy intake software designed to make you select from a dropdown box of "magic words."

They do so under the legal guise of "streamlining" billing information. 

It is not fraud if it is true.

Grey, medicine is grey...

edit: and once word gets out you are making accusations of fraud, you will be the most moral unemployed and unemployable care provider ever.


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## Vladimir

*Often Times...*

Veneficus, I can agree with you to a certain extent, but not completely. Some companies go so far as to tell E.M.T.'s to write certain words that upgrades reimbursement, in order to get a higher billing code. I am not sure if you know anything about ambulance billing, but medicare pays more (than regular bls-ER calls) when emt-b's transport als-ER patients.
For example, chest pain for a rash on the chest that's painful (makes it ALS), shortness of breath if thats the regular for the patient (Makes it ALS), and so on and on...

Calling things a grey area, is like saying a white lie. You can not be one of those EMT's that makes an excuse to not do your job properly. I am not a fire groupie, or a ricky rescue type, but I know the way the "feds" (literally the fbi and cms) interview EMTs all the time nowadays in Los Angeles County, and probably all over the nation, it is time to review what you are doing. And also just because everybody does it, is not a good excuse. Do you know hospitals are getting (literally) raided too? These hospitals are not infallable... and also, I have no idea how familiar you are with billing software, but you have to use ICD9 and CPT codes, and simple sounding diagnoses have many codes sometimes and they get extremely specific.


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## Vladimir

*One other thing...*

EMT's are liable for what they write. If an EMT beleives there is being fraud committed, report it. You can also anonomously report it, it is your civic duty. Remember, you can be prosecuted if you commit fraud. They will also look at ALL of your patient care reports, and if an employer persuaded you to defraud the United State government, you still defrauded the United States government! 

For example when Greybor ambuance was raided in 02, they followed every single ambulance, and went into their offices simultaneously and had everybody at gun point. Even EMT's taking showers were at gun point... And many people (mostly ownership AND management) went to prison.


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## Amberlamps916

It was really hard to keep a straight face.....


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## Vladimir

I can imagine... you work for elite (I think elite is armenian, maybe russian... but its one of those two for sure)huh? lol, because I think the other big armenian company was transaid before they had their issues... lol
These guys are so crazy man, they want people to do crazy things, and do not see an issue with any of it. I have been asked to change stuff on run sheets too, I just said I was in a hurry and left... they usually had my partners change paperwork probably. Thats why I always just drove. I even got fired once for not transporting a patient with the proper paperwork, they were refusing a call and had no 5150 and they were not on a conservatorship... one thing about this field dude is CYA!!!!! Cover Your A$$!


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## Anjel

What do you have against armanians?


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## ffemt8978

A word to the wise...leave the racial aspect out of this discussion.


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## Vladimir

*Nothing*

... when i said these guys, I meant ambulance company owners and management... not aremenians.


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## jemt

I'm not comprehending this clearly, all patients that are IFT transports require a form that states why they need to go by stretcher signed by a Dr., yet the EMT writing the narrative is also responsible for fraud if the pt. doesn't need to go by stretcher?

The last company I worked for required the EMT's to write the reason for BLS transport at the end of the narrative (reasons were provided for us).


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## Veneficus

jemt said:


> I'm not comprehending this clearly, all patients that are IFT transports require a form that states why they need to go by stretcher signed by a Dr., yet the EMT writing the narrative is also responsible for fraud if the pt. doesn't need to go by stretcher?
> 
> The last company I worked for required the EMT's to write the reason for BLS transport at the end of the narrative (reasons were provided for us).



The classic EMS thinking.

Authority without responsibility.

In a nutshell, you are responsible for commiting fraud. A patient chart is a legal document, if you falsifying it knowingly, you can be held accountable.

Now having covered that. I am not sure I would try to use coercion as a defense. It has a history of not working in spectacular ways.

But I think you have to have some perspective...

I doubt the US attorney wants to put a bunch of minimum wage earning EMTs in federal prison. 

They want big fish. Which may be your boss.

Inevitably there is no honor among thieves, They will point the finger at you, you will point at them.

But these questionable morals companies have you over a barrel. You have no markitable education in a saturated maket that is really trucking around human flesh for more money than it is worth.

You are better off in another field. 

At best, you will testify against your former employer and be out of a job.

At worst you might be "an example" an attorney is trying to set.


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## jemt

I agree with all your points about how backwards IFT is, but I don't understand how a EMT could be held responsible for a pt. going by stretcher when its not needed.


Why/how is a EMT expected to know medicare guidelines for BLS transport?

I also dont understand how a brand new EMT who is told by his employer to go pick this patient up at this time and write what happens, is committing fraud.


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## usalsfyre

jemt said:


> I agree with all your points about how backwards IFT is, but I don't understand how a EMT could be held responsible for a pt. going by stretcher when its not needed.
> 
> 
> Why/how is a EMT expected to know medicare guidelines for BLS transport?
> 
> I also dont understand how a brand new EMT who is told by his employer to go pick this patient up at this time and write what happens, is committing fraud.



If you knowingly document SA reason that is not true and consistent with your assessment, it is fraud. Doesn't matter who told you to write what, where.

All we ask of our providers is to document accurately and completely and let someone else worry about getting paid.


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## Veneficus

jemt said:


> I agree with all your points about how backwards IFT is, but I don't understand how a EMT could be held responsible for a pt. going by stretcher when its not needed..



Because you are writing the report that your employer is going to submit for payment.

It is based on your word if this patient does in fact meet the criteria for ambulance transport.

A doctor has to sign a need form also.

It is a check in the system.

Think of it like the movie crimson tide. the captain (doctor) gives an order. 
The xo (you) have to verify that order.

If you falsely verify, you have commited a federal crime. 

Now if your company is upstanding, they hire an expert and educate you on medicare billing, so you know what you can do and what you can't.

Some even buy software that only lets you select what you can and what you can't. 

If your company is questionable or shady, they will tell you what to write. You may choose to do that, which implicates you as an accessory, or you can suffer ill consequences including termination.

Without your report and signature, aa bill cannot be submitted.




jemt said:


> Why/how is a EMT expected to know medicare guidelines for BLS transport?.



Well, you can take responsibility and educate yourself or your employer may pay to have you educated. (fat chance on the latter) But if you are signing a legal document to get money from the federal government, you really may want to figure out what is acceptable and what is criminal.





jemt said:


> I also dont understand how a brand new EMT who is told by his employer to go pick this patient up at this time and write what happens, is committing fraud.



Your employer does not set the standard on what is billable and what is not. But you are a check in the system to make sure that only appropriate patients get billed. 

It is unfortunate that they do not spend time on the in EMT class, because most EMTs work in IFT, but the failure of the system is beyond our control. 

If you write the patient couldn't sit in a wheel chair on your report and they can (for extended time) you lied. 

If you write the patient is having chest pain and the patient is not, you lied. 

This may come as a shock, but government officials, including police are permitted to lie to you, you are not permitted to lie to them. 

Especially when it costs them money.

Now there are some caviats to what I wrote here, for instance if a patient cannot sit in a wheelchair for an extended period. (which is a bit subjective) Then they do qualify.

I know doctors who sign those forms without reading them or have their underlings sign them just to open up bed space or because the patient cannot afford to pay for transport. 

If you comply with such, write a legal document saying such, and your company submits a bill which is paid, it is like being the driver of the get-a-way car. You didn't do the robbing, but you are part of the scheme.

There are many less than honorable companies and even honorable ones that have exploited the system of payment over the years and still do. Now there is just a very visible crackdown on it.


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## jemt

I see the light now!

IF  I lie on a narrative I'm committing fraud,but if I just write what happens I'm not committing fraud even if the IFT pt. doesn't need stretcher transport?


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## Veneficus

jemt said:


> I see the light now!
> 
> IF  I lie on a narrative I'm committing fraud,but if I just write what happens I'm not committing fraud even if the IFT pt. doesn't need stretcher transport?



exactly.


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## jemt

Thank you for clarifying.


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## shfd739

usalsfyre said:


> If you knowingly document SA reason that is not true and consistent with your assessment, it is fraud. Doesn't matter who told you to write what, where.
> 
> All we ask of our providers is to document accurately and completely and let someone else worry about getting paid.



Same here. Write what you see and the let the company figure out the billing/payment on the backend.


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## Tigger

Vladimir said:


> EMT's are liable for what they write. If an EMT beleives there is being fraud committed, report it. You can also anonomously report it, it is your civic duty. Remember, you can be prosecuted if you commit fraud. They will also look at ALL of your patient care reports, and if an employer persuaded you to defraud the United State government, you still defrauded the United States government!
> 
> For example when Greybor ambuance was raided in 02, they followed every single ambulance, and went into their offices simultaneously and had everybody at gun point. Even EMT's taking showers were at gun point... And many people (mostly ownership AND management) went to prison.



I highly doubt anyone was held at gunpoint at any point during that investigation, or most other white collar fraud investigations.


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## Vladimir

Tigger said:


> I highly doubt anyone was held at gunpoint at any point during that investigation, or most other white collar fraud investigations.



Actually, I know a few people that worked there... and one of the guys I was talking to was pulled out of the shower at gun point. It is a federal crime, and they can not let the owners know what is going on... so they can get them by surprise!


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## Vladimir

*OKOKOK... this is how it works...*

Their seems to be a little confusion about billing and fraud. 

Here is the first thing, a biller can make something up and submit without paperwork! But this is illegal, and they could face serious prison time.
Also, the run sheets you fill out are never sent to the insurance company or medicare (if so rarely)... no one ever sees your runs or narratives, not even chp... It just wouldnt be efficient. Think about it, it wouldnt merit the expense of hiring all the auditors necessary!

An E.M.T. commits fraud when they lie on these forms because these forms are audited by medicare if their is ever a problem... and if these forms show the E.M.T. was complicit with the fraud then this is a problem. Because, ultimately you could be made an example out of, even though they usually go only after the big fish.

When fraud is detected or investigated, they will audit the patient care reports, and you dont want to make the FBI's job harder, do you?

Also, an ambulance can transport anybody they wish, even if they do not need an ambulance (and yes, no matter if you do not get paid, legally you must still fill out a patient care report)... but that doesnt mean that they will get reimbursed by the insurance company. Some may attempt reimbursement, and they may lie and cheat, and attempt to get you to lie and cheat... but if i were you, i'd keep my nose clean. It can be potentially sooo much worse for you if you do not!


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## Veneficus

Vladimir said:


> Their seems to be a little confusion about billing and fraud.
> 
> Here is the first thing, a biller can make something up and submit without paperwork! But this is illegal, and they could face serious prison time.
> Also, the run sheets you fill out are never sent to the insurance company or medicare (if so rarely)... no one ever sees your runs or narratives, not even chp... It just wouldnt be efficient. Think about it, it wouldnt merit the expense of hiring all the auditors necessary!



This is a bit oversimplified.

As I understand, a form which is generated based on your run report is sent for reimbursement.

Upon receipt, one of 3 actions is generated.

1. denial
2. acceptance and immediate pay
3. request for more information and up to 90 days to pay(audit)

The real danger is number 2. 

Because if you falsified something to make it go through, it is your biggest chance of being caught.

I also understand that one of the way anyone decides to have a closer look at you is by the percentage of immediately accepted payouts to denials and audits compared to other similar companies.

If you are audited and then denied that is not a crime.

There are legitimate uses of "magic words" to expedite billing. The problem comes when you are using these words when they shouldn't be. (like on all of your documents regardless of pt. condition)

I only ever met one guy who admitted working for the FBI, on career day in highschool, they are a rather sharp bunch and generally do not target the peons. 

Getting rounded up in a bust and released isn't the end of the world. But I bet it makes for a really scary and bad day.


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## gonefishing

I was askd at my old company to change a run sheet from standing pt to sitting patient.  To put that we had to GS the pt onto the gurney which was totally false.  PT was a medicare  pt I refused and quit.  Found a legit large company and havnt lookd back! my supervisors words "bro if we put that the pt was standing and got on the gurney, we wont get paid for it."  This was at a private residence so it landed on me.  They use to pick up out of LA county with out LACO stickers and still do .  Simple advise leave and dont ever lie.  These companys exsist all over LA.


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## Amberlamps916

Hmmmm, the use of the word "bro"......was this company out of Glendale?


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## Vladimir

Veneficus... That probably would ruin anybody's day! lol
But yeah, that's close to being it... but billing is relatively easy, everything is automated, billers want to make it sound like it is the hardest thing in the world, but it really is SIMPLE!!! A lot of billers make a percentage of the gross! so sometimes 5-10%!!! 

btw, You dont even use words! its all codes! You cant use "magic words", it all boils down to using you as a scapegoat! lmao...
if they can prove you incompetently used a "magic word" to fill out the run sheets, then when they get audited, there was no malintent! they will still have to pay back money if they get caught, but they wont get into trouble for fraud... one of the components for fraud is intention.


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## Vladimir

by the way... do you even know how many companies have been investigated or shut down for all sorts of things in the last year or so??? A LOT!!!
I can think of 10 in the Los Angeles area, all within a 20 mile radius!!!

Beleive me, regular employees do not find out a lot of stuff that goes on in the industry... Just remember, YOU ARE NOT JUST A FLESH HAULER! You are a medical professional who has the lives of real people in your hands, that depend on your decernment, and the public at large looks up at you, and this gives you a degree of authority... God help the victim of a TC that crosses paths with an EMT that views himself as a "Flesh Hauler"!!!


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## gonefishing

Addrobo87 said:


> Hmmmm, the use of the word "bro"......was this company out of Glendale?



LOL! No comment.  :lol:


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## Amberlamps916

Status Update.....We're almost 14....10-9?


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## gonefishing

Addrobo87 said:


> Status Update.....We're almost 14....10-9?



Yea.... You guessed it.


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## Amberlamps916

You've moved on to greener pastures?


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## gonefishing

Addrobo87 said:


> You've moved on to greener pastures?



Oh yes! Big time!


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## Amberlamps916

I've been there for 6 months


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## Veneficus

Vladimir said:


> Veneficus... That probably would ruin anybody's day! lol
> But yeah, that's close to being it... but billing is relatively easy, everything is automated, billers want to make it sound like it is the hardest thing in the world, but it really is SIMPLE!!! A lot of billers make a percentage of the gross! so sometimes 5-10%!!!
> 
> btw, You dont even use words! its all codes! You cant use "magic words", it all boils down to using you as a scapegoat! lmao...
> if they can prove you incompetently used a "magic word" to fill out the run sheets, then when they get audited, there was no malintent! they will still have to pay back money if they get caught, but they wont get into trouble for fraud... one of the components for fraud is intention.



Figuring out how to make stuff up to get paid and not get audited or busted is hard work


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## Veneficus

Vladimir said:


> by the way... do you even know how many companies have been investigated or shut down for all sorts of things in the last year or so??? A LOT!!!
> I can think of 10 in the Los Angeles area, all within a 20 mile radius!!!
> 
> Beleive me, regular employees do not find out a lot of stuff that goes on in the industry... Just remember, YOU ARE NOT JUST A FLESH HAULER! You are a medical professional who has the lives of real people in your hands, that depend on your decernment, and the public at large looks up at you, and this gives you a degree of authority... God help the victim of a TC that crosses paths with an EMT that views himself as a "Flesh Hauler"!!!



I don't haul flesh  

Thanks for the insights. Inside information is always appreciated.

If I haven't mentioned before, I suspect much of the medicare/medicade fraud going on is organized, not random companies.

Either there is an expert with inside knowledge trying to stay just legal in order to make some money. (As we saw in Florida several times after they were caught)

or an actual organized crime link, that was playing at odd of prior lax enforcement and basically taking what they could get before being caught.

As for increased enforcement, I think it is a political game. As I mentioned, the amount of medicare fraud while seemingly like a lot, in the grand scheme probaly isn't much. 

But somebody needs to be able to say they are "doing something" to reduce medicare costs and who doesn't rally around "cracking down on the bad guys?"

Sounds a lot better than "slashing benefits" on the TV.


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## Vladimir

You're right, but It is no political game... because the government hates those who conspire against it too much!h34r:


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