Are you a nurse practitioner or clinician whose employer pushes you to bill at higher levels than the care you gave?
Billing a visit at a higher level than the care justified is called upcoding. When it is billed to Medicare or Medicaid, it can violate the False Claims Act. Employees who report it can be whistleblowers.
CASE EXAMPLE: CAREWELL URGENT CARE, $2.1 MILLION
Aileen Cartier, a nurse practitioner at CareWell Urgent Care Centers, reported that CareWell directed its clinicians to perform more thorough exams than necessary so it could bill a “Level 4” visit and collect higher reimbursement from Medicare and Medicaid. CareWell paid over $2.1 million. Jeff Newman Law represented her.
SIGNS TO WATCH FOR
– You are told to document or examine more than the visit requires.
– The company sets billing levels, not the care you provided.
– You raised concerns and were ignored.
Q&A
How can I determine whether I have a viable claim? We’ll assess it with you, at no cost.
What protections will I have from retaliation? Federal law protects employees from retaliation for reporting fraud.
How are legal fees structured? There is no fee unless we win.
Call 617-823-3217 for a free, confidential consultation.
