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Case of Urgent Care Doctors Engaging in Insurance Fraud Highlights Importance of Clinics Reputation

October 27, 2015
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One of the newest trends in healthcare today is that of the urgent care facility. Whether it be for STD testing, a flu shot, or some type of first-aid treatment these walk in medical clinics are becoming more and more popular for their cost, convenience, and overall efficiency compared to their traditional doctor office and emergency room counterparts. In total there are over 6,800 in the U.S. today that see an estimated three million patients every week, according to the Urgent Care Association of America.

While the reasons for choosing these types of urgent care facilities grows every day as improvements are constantly being made to make them even better, as with any industry there are things to watch out for. A recent case highlights the need for consumers to ensure they’re getting and paying for the right services when at urgent care centers. Any place there are goods or services being exchanged for payments has the risk of fraud and deceit and that is allegedly what happened at an urgent care facility in Scranton, Pennsylvania.

According to the Scranton-area ABC affiliate WNEP.com, two doctors were charged in a fraud case stemming from a raid of an Advanced Urgent Care clinic this past July. Dr. Rajaa Nebbari, 44, and Dr. Chetan Byhadgi, 52, both face charges of Medicaid fraud, conspiracy, theft by deception, and insurance fraud. The Pennsylvania state attorney general’s office alleges that the pair took part in a scheme that involved them submitting false insurance claims to medical assistance, Medicare programs, and private insurance companies. They also allegedly had unqualified employees write prescriptions for controlled substances.

While none of the reports indicate that patients were involved or harmed in any sort of way through these criminal activities, it’s a good lesson for people to keep in mind when choosing an urgent care facility. The benefits and advantages these clinics have are well-documented, and the average urgent care center trip alone will cost about $150 compared to the average hospital visit of $1,500. This recent event should not give people cause for concern in utilizing similar services, but rather the knowledge that even people in an industry dedicated to helping people can partake in criminal activity.

The doctors involved no longer are employed with the urgent care facility and are awaiting a scheduled court date.

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