While working at the medical office where you are a reimbursement specialist, you notice that a Medicare patient has many more laboratory tests done than a non-Medicare patient. Consider these questions in your initial post to the Discussion Board.
- What is the difference between fraud and abuse?
- Could this be a case of fraud or abuse? Why or why not?
- Is it appropriate to notify your office manager?
- How would you go about investigating this particular case? What would you review? How would you proceed?
- What is the impact of having fraud and abuse occur at your facility?