15 Types of Medical Billing Fraud & Abuse

1. Upcoding
2. Cloning
3. Phantom Billing
4. Inflated Hospital Bills
5. Service Unbundling or Fragmentation
6. Self-Referrals
7. Repeat Billing
8. Length of Stay
9. Correct charge for type of room
10. Time in OR
11. Keystroke Mistake
12. Cancelled Service
13. No Medical Value
14. Standard of Care
15. Unnecessary Treatment

Notes: It is estimated that medical fraud and abuse accounts for $80 billion worth of healthcare costs in the US. We highlight 15 types of medical billing fraud and abuse affecting the US healthcare system.