There are even courses that teach people how take advantage of the system. Although most doctors probably are following proper protocols, the small percentage that do not become increasingly aggressive and abusive. Sometimes it's not the providers, it's the billing office. Those bilking the system are also hurting their colleagues. Half the dollars spent on health care reimbursement is being provided by federal and state governments. That being said, when someone is taking advantage of the system and overcharging, it depletes the finances available, making it more difficult for those filing correctly to receive fair and adequate reimbursement.

Part of the problem is the fact that there's not much of a deterrent in place to prevent people from practicing health care fraud. Often, even when a fraudulent provider is identified, there is rarely a suspension of a license or other definitive legal action. Sometimes, individuals are put on probation, sometimes the problem is ignored entirely -particularly if the total cost is not an exorbitant amount. So this abuse by a small percentage of the providers continues to plague society and damage our health care system.

Health care fraud is a much costlier issue than some of the more well known insurance frauds. It is far more costly than slip and fall injuries, car thefts, property and casualty damages and the related insurance fraud, but because the health care industry views providers as part of their delivery system these abuses seem to be ignored or only mildly punished.

It's easy to feel angry when being confronted with these facts; fortunately, it's also easy to fight back. As a practitioner, or a billing department, be aware of the correct ways to file claims for reimbursement. This will help to ensure your funds are sent promptly and it will also cut down on the time it takes to complete the paperwork, helping to save you even more. As a patient be sure you understand what services are being provided and what tests are being conducted on you and the rationale for them. If something doesn't seem legitimate, ask questions - it's your right to do so. Review your EOBs carefully and make sure you understand what your insurer is paying for. Our company works hard every day with the goal of stopping this waste and abuse and redirecting up to $300 billion a year into better and more comprehensive health care for all US citizens.

Dr. Barry Johnson is a founding partner of HCI and has served as CEO/President since January 2001. He is a coding and reimbursement expert and has over 22 years of experience in software and database development. He has authored two books and numerous articles on medical and dental coding and reimbursement issues and health care fraud prevention. Prior to working for Medicode, Dr. Johnson practiced dentistry for 20 years. Dr. Johnson is a Certified Dental Consultant and a Fellow of the Academy of General Dentistry.

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