And when you get caught, you lose your medical license.

Can you really fake bill enough before getting caught to be worth burning an M.D.?

I never really understood this angle. Say the insurers use a phone call to verify 1% of treatments with the patient. Say 20% of those calls are answered and produce a coherent reply. That ought to be enough to make the expected payoff negative.

Either way, this problem isn't unique to the medical world. Every other industry has to prevent fraudulent invoicing.

I assume that if you do fake billing, you wouldn't do that with your own identity, so the risk of losing a medical license isn't there.

Nobody accepts anonymous medical invoices.

But they do accept ones with forgef credentials and redirected bank payments ^.^

If you can "redirect" somebody's money you don't need to bother stealing patient medical records.

Then you'd be surprised to hear about the income tax return scam back in the day where even lay people were able to achieve just that, for 2 million bucks specifically ^.^

https://www.google.com/amp/s/www.nydailynews.com/news/nation...

And they didn't need any medical records to do it!

... which was pretty much my point.

If they can steal money out of doctors' bank accounts, or redirect it on its way in, they don't need patient data. The doctors already have patients. And payments coming in. This isn't like income tax refunds where the payer pays each individual.

In fact, if they have patient data, it's stupid to use it. What insurer isn't going to notice some doctor suddenly getting a thousand new patients all in the course of one week?

Sorry man, it still doesn't add up. If you're equipped to do this at all you're equipped to do it without needing patient data.