The three quality issues in the case of Antebi are; charging for services not offered, excessive charges and not giving the patients services they ought to get. Antebi billed Medicaid, Medicare and other insurance providers over $ 24.6 million for services that he did not provide to concerned patients. The investigators found he billed them when he was outside the state of New Jersey (U.S. DEPARTMENT OF JUSTICE, 2020). But, does it mean one has to be in contact with a physician for the billing not to be a fraud? What if Antebi was using telehealth to reach the patients? What if those who were charged colluded with Antebi to defraud government and insurance companies?
On excessive billing, Antebi billed the clients even in hours he was out of his office. Though, he may be on the wrong I think even the people carrying out surveillance are to blame because they allowed the billing to continue to over 300 times. Also, Antebi may have charged the client for consulting him even when out of office. It is possible he charged the patients excessively for requesting his services during out of office hours.
Patients have a right to access quality care. Physicians should not skip procedures or use of necessary tools and equipment’s as Antebi did. This shows the Physician offered substandard services to people who were entitled them. this is a critical failure on the side of the medic. The patients also ought to have complained to the relevant authorities before the scandals became too much.
Health services billing violations
Antebi violated billing practices that include; billing services that were not rendered, inflated hospital debits and up coding. This is because he billed Medicaid, Medicare and Insurance company’s services that the patient did not receive. For example, he billed Medicare for use of equipment’s he did not use as in most cases he met patients even in hospital corridors and waiting benches. Two, he overcharged services rendered by excessive claims. Three, he assigned reimbursement of diagnosis higher amount than the services provided (Clements, 2015).
Use of Antebi case for training
This case can be used to train new employees during induction and existing employees on best billing practices. This is because there is too much violations that health care professionals can carry out in order to increase their incomes. It can be used to portray the kind of fine that those who defraud the government and insurance companies or abuse billing practices are likely to get.
