Professional Billers and Coders have a moral, legal, and ethical responsibility to submit claims properly. It is vital that students understand the high stakes. To help you get a feel for the scope of the issue of fraud explore the oig.hhs.gov web site.

Explore the different aspects of billing and coding fraud.
Include all the following aspects in the discussion:

Choose two examples of fraud that interest you

Summarize the case

Discuss the role the coder played in the fraud

Consider what your response would/should be if you were asked to be a part of the fraud

Discuss if ignorance of the billing/coding rules provides sufficient legal protection

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