“We can find no evidence in the medical records of any psychosocial history, no evidence of comprehensive multi or detailed single organ system assessment, no formulation of differential diagnoses, no evidence of comprehensive management plan of significant complexity,” they said. They noted that a neurologist and a geriatrician each separately billed Ms King’s health fund for a 45-minute consultation and management plan, which required a psychosocial history and medication review. They noted other anaesthetic bills that didn’t match the medical records included a 45-minute consultation and management plan, while Ms King was in a coma. Dr Sutherland and Dr Faux said on one occasion a pre-anaesthesia assessment did not meet Medicare requirements. Much of the questionable billing took place when Ms King was sedated and ventilated and in a coma after spinal fusion surgery went horribly wrong.<\/p>\n
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Specialized attorneys experienced in healthcare fraud defense understand complex billing regulations and can identify legitimate explanations for disputed claims. We have helped numerous healthcare providers to automate their medical billing and coding tasks and remove the burden from their teams. Healthcare providers can use AI healthcare fraud detection to avoid fraudulent activities.<\/p>\n