I am really bothered by the fact that there have been so many responses
to this issue which have advocated less than honest approaches to
reaching a solution.

As professionals advocating for a cause that we truly believe in, we
should always deal with others in a straight forward and honest manner.
The very foundation of respect for our profession and our colleagues
could easily be seriously undermined if we were found to be advocating
insurance fraud, for that is what it amounts to when one misrepresents
the need for insurance covered services or equipment.

I'm not sure what the penalty is for private insurance cases, but for
federally funded programs the fine is $10,000 per billing line item when
fraud is shown to have occurred.  And ignorance of the law is not a
defense when charges are brought.  Saw a case where an OB office was
fined over $.25 million because a clerk billed for a full urine dipstick
rather than the three item dipstick they used on preg. pts.  The
reimbursement amount was something like 97 cents for the three item dip
and $3.27 for the full panel.  But think how many times that test is
done daily in a busy ob office.  Doctors didn't even know the clerk was
doing this.

Melinda Hoskins, MS, RN

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