Overbilling:
Overbilling is the practice of billing more units than the time spent providing MNT
For example, if you provide 15 minutes of MNT to a member and bill 4 units that is overbilling.
It can happen intentionally, where a healthcare provider intentionally inflates the bill for personal gain.
It can occur accidentally due to mistakes or errors in billing.
Mistakes or errors must be corrected. Instances of mistakes should be reported immediately.
Double billing:
The practice of charging a member twice for the same service, either intentionally or accidentally.
Double billing may also occur when an RD bills family members twice.
E.g. if you spend 60 minutes providing MNT to both a mother and child you can only bill a maximum of 4 units across both members (2 units for mother and 2 units for child).
Overbilling and Double Billing are considered fraud and that could result in financial penalties, loss of license, and exclusion from government programs.
Both practices can lead to member dissatisfaction, health plan disputes, and potentially legal issues if not corrected.
What should I do to adjust billing units?
RDs are able to edit billing information on a closed chart within 72 hours of the visit start time
Open Session Details in a post closed chart
Click on Request Billing Edit
Complete Request Billing edit form
Click on Submit
Overbilling is considered fraud or unethical behavior, especially if done deliberately for financial gain