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Johanna Ferguson wrote:

Hi, guys —

In my job, I recently found out that we are charging more for services than what we really should be. I am the biller at this medical officer and we use a service code that has a higher payment and we send this to the insurance companies.

I did not notice this and I am not sure why the insurance companies have not noticed it. Considering other factors, it should be easy to spot but they always seem to pay us.

  • Can I stay at my current job or should I look for a new one?

I don't have a lot of experience and would have trouble finding a new job.

  • If I have to get a new job, can I stay here while looking for another job or until I get enough experience?
  • Would it matter if, in my current job, I just help out instead of doing the bills?

I think it is a mortal sin but I have no idea in my circumstances.

Johanna

  { If my company is overbilling the insurance company, should I look for a new job? }

Bob replied:

Johanna,

You are not responsible for the fraud but, now that you know, you cannot participate in it. What they are doing is criminal and should be brought to the attention of the authorities.

I would:

  • look for a new job
  • have no involvement with billing in the meantime, and
  • alert the insurance company who can involve the authorities in an investigation for fraud.

Peace,

Bob Kirby

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