When an HMO accuses a physician of insurance fraud for overcharging for their services, the physician can be reported to the Department of Health with fraudulent billing charges. It is also possible for an OPMC investigation to be prompted by these accusations. It is common for a physician accused of insurance fraud to negotiate a settlement with the HMO.
If you have been accused of insurance fraud as a physician, it is important that you speak with a knowledgeable and understanding New York medical misconduct defense attorney who can walk you through the process ahead. The legal team atWalker Medical Law understands all that medical professionals have to go through to obtain their medical license and build their practice. We are dedicated to doing everything in our power to help those who have been accused of wrongdoings to keep their medical license they worked so hard to obtain. Continue reading to discover what happens if a physician is accused of insurance fraud, and how to avoid being accused of insurance fraud as a physician in the future.
What happens if I am a physician accused of insurance fraud?
If you have been accused of insurance fraud it is important to have a plan in place and not to panic. It is possible for this to be a simple discrepancy or mistake that can be easily taken care of and remedied.
However, if the HMO believes that you have purposefully overcharged for your services as a physician, they may take action by reporting the incident to the Department of Health. If this occurs, you will likely have to repay the amount that was believed to be overcharged and an investigation will be prompted by the OPMC. When a medical professional is investigated by the OPMC, there is a potential for them to lose their medical license.
If you have been accused of insurance fraud, it is time to reach out to an experienced medical misconduct attorney who will help you negotiate a settlement with the HMO to resolve the matter in a quick and painless process.
How can I avoid being accused of insurance fraud as a physician?
To avoid being accused of insurance fraud as a physician, it is important to retain the services of a billing firm for guidance to ensure your practice has proper billing systems in place. Hiring a billing firm will benefit your practice in two ways: you will be kept out of billing issues with the HMO and you will learn how to legally maximize your billing to capture the highest amount permitted.
Contact our experienced New York City firm
When a medical professional is accused of misconduct, they must retain strong legal representation. If you require a medical law attorney for your legal matters, call Paul E. Walker, an experienced New York City OPMC & OPD Lawyer. Please contact the Walker Medical Law firm to set up a free initial consultation.