Fraudulent billing?

I saw an incompetent NP at a private practice several times. The insurance claim submitted was a standard statement with zero individual pt information and was so dated that it referenced modalities of care that were no longer offered.

I never spent more than 2 minutes face-to-face with this NP. There were no records, tests, etc. for them to review.

However, the claim submitted for each visit stated that the NP spent 25-28 minutes with the pt and coordinating their care. Again, I saw them literally 2 minutes at most at each visit (I was simply handed discharge paperwork) and there were no records to review.

When I a questioned an employee about the claims submitted to my insurance, I was told that the 25-28 minutes included my interaction with the receptionist, intake by MA, etc. Intake I can understand, but can practices bill for simple office procedures like signing in patients and handling their paperwork??

I suspect they simply were billing for higher levels of care to receive higher reimbursements. Could anyone weigh in on this?

edit a word

submitted by /u/Correct_Librarian425
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