Insurance fraud detected at Colorado Springs doctor’s office

medical insurance fraud

It has been discovered that they were charging insurers for appointments that had been cancelled.

A doctor in Colorado Springs has now agreed to pay more than $86,000 to the United States government after it was discovered that he had been improperly making claims that constituted insurance fraud to a military insurer for administrative services that continued from 2008 through 2013.

Internal audits that had been performed by the TriCare Military Health System revealed the billing practice.

These audits showed that the billing practices of Dr. David Hatfield were actually considered to be insurance fraud. These practices allowed for the billing of the government agency for “time spent filling out timesheets, time spent for cancelled appointments where no therapy was provided, or time or money spent on supplies or food.” That quote was obtained from a press release that was issued by the United States Attorney’s Office.

The investigation into this case of insurance fraud was continued for a period of just over a year.

medical insurance fraudAccording to Jeff Dorschner, a from the U.S. Department of Justice, “The investigation was a little over a year,” adding that “The quality of the care provided by the doctor is not in question.” The issue is specific to the fact that the government was being billed for things that were not allowed. Dorschner explained that health care providers “can only submit bills for the services that [they] conducted. They are not allowed to bill the government for administrative things.”

The good news is that the patients of Dr. Hatfield will not experience any alteration in their medical bills or coverage premiums as a result of what has occurred. Instead, Dorschner said that the “victim” in this case is the American government. He said that “It is strictly money which comes out of the Federal budget.”

The settlement that has been established between Dr. Hatfield and the U.S. Government means that the doctor will need to pay back $86,675.68, which can be repaid in monthly installments of $1,400. This, despite the fact that Droschner says that the loss was actually considerably larger than that agreed-upon figure.

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