The World of Coding and Medical Billing Fraud – Part 3: Excessive Drug Testing

by Andrea Vieten
blood tube and blood test
Header photo - Getty Images

The U.S. has been experiencing a deadly crisis involving he over-use of opiate drugs over the past several years. As a result, the use of drug testing has expanded exponentially. Drug tests help medical providers identify drug use and abuse. The consumption of illicit or unprescribed drugs that can interfere with the prescribed medications can also be detected. However, medical providers are extensively overusing drug testing which results in large financial losses in health insurance, property and casualty insurance, as well as workers’ compensation.

As part of the Fraud Fact Friday series, our medical billing experts, Tami Rockholt and Mike Fossey, describe the problem of excessive drug testing and explain what you can do as an insured or a claims adjuster to prevent unnecessary charges.

RiskShield automatically detects noncompliant overuse of drug testing and creates a denial letter that can be sent out by claims adjusters to save hundreds or even thousands of dollars.

Video Notes:

Introduction (0:00)

Unnecessary drug tests (0:51)

How do detect excessive drug testing (1:13)

Which actions to take when suspecting unnecessary drug test (2:10)

Frequency of excessive drug testing (2:54)

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About the author

  • Andrea Vieten

    As a Senior Business Consultant at INFORM GmbH, Andrea Vieten has been responsible for managing global implementation projects in the financial industry. With more than 10 years of experience, she has consulted and guided many financial institutions to the successful implementation of intelligent decision systems in the areas of risk, processes and compliance.

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