Discussion Reply- Response 1-2 paragraphs with 1-2 references

Patrick Wallace

Hello all,

Fraudulent billing in this organization could result in the arrest of this billing specialist and potential fines for the organization upon investigation. If the billing specialist knowingly input false medical bills it is illegal and would be a federal crime and punishable with jail time or major fines.

The manager and hospital should respond be immediately firing the billing specialist and reporting the issue to the required party according to hospital procedures. This will cause an investigation and the reporting and firing of the specialist may keep the hospital from injuring any major fines due to their cooperation. This would require the full cooperation of the hospital as it is a federal crime once the bill is process for payment under the federal false claims act ( Constantine 2019).

The hospital should prevent this from occurring again by keeping proper records and checking these records monthly. This would not of been uncovered if not for the audit so the ability to check the work of those whom are employed in order to improve as an organization and cover your tracks in terms of fines or charges.

References:

Medical billing fraud. Constantine Cannon. (2019, November 30). Retrieved January 14, 2022, from https://constantinecannon.com/practice/whistleblower/whistleblower-types/healthcare-fraud/billing-fraud/