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Scott Wells MD: Defrauding His Own Patients? (2024)

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Scott Wells MD has received allegations of defrauding his patients. Find out if those allegations are true or not in this review.

Dr. Scott Wells is a highly experienced plastic surgeon who has been practicing in New York for over 25 years. He runs a cosmetic surgery clinic in Great Neck and on Park Avenue, where he serves as the surgical director. Dr. Wells specializes in various rejuvenating procedures, including facelifts, eyelid lifts, and body contouring treatments like liposuction and breast surgeries.

He’s known for his expertise in using innovative techniques such as laser treatments, PRP, and stem cells for rejuvenation. Dr. Wells also offers cosmetic injectable procedures like Botox and fillers, and he’s skilled in using laser technology to minimize bruising for his patients.

Additionally, Dr. Wells has developed programs like SkinGymTM and Beauty For LifeTM to help his clients maintain youthful appearances and address anti-aging concerns.

Dr. Wells received his education from New York Medical College and Johns Hopkins University. He’s recognized as a fellow of the American College of Surgeons and has received several honors for his work in the field of plastic surgery.

Scott Wells MD: Reviews

A patient complained that Dr. Scott Wells charged additional fees that were not part of the initial agreement, even after agreeing to accept payment from their insurance company. They expressed concerns about this practice, suggesting it may be dishonest, and advised others to be cautious when dealing with Dr. Wells.

Is Scott Wells MD Charging Unnecessarily?

According to a report on Money Talks News:

What is upcoding?

Upcoding is a term used in the medical field to describe a type of overcharging. It happens when a healthcare provider intentionally bills for more expensive services or diagnoses than what was actually provided or treated. This is often done to receive higher payments from the patient’s insurance company.

For example, here are three instances of upcoding highlighted by the FBI’s Health Care Fraud Unit:

  1. Billing a routine follow-up appointment as a first-time or extensive office visit.
  2. Charging for individual therapy sessions when group therapy was actually provided.
  3. Advertising sessions as lasting longer than they actually did.

Upcoding gained significant attention in the 1990s when many hospitals were accused of upcoding patient diagnoses. Columbia/HCA, one of the largest offenders, agreed to pay $1.5 billion in fines, penalties, and restitution, making it the biggest healthcare fraud case in American history.

Unfortunately, upcoding remains a problem today. For instance, SCAN Health Plan recently settled a $327 million investigation into overcharging California’s Medicaid program, marking it as the largest-ever Medi-Cal overpayment settlement.

Why is it referred to as upcoding?

The term “upcoding” is derived from the concept of “upping” or increasing the level of billing for a service to make it more expensive. In the context of medical billing, it refers to the practice of intentionally selecting codes for more expensive services or procedures than what was actually performed or provided.

To understand how upcoding works, it’s essential to grasp the process of coding in healthcare. Each medical service or procedure is assigned a specific code known as a CPT code (Current Procedural Terminology). These codes serve as a standardized way of describing medical procedures and services for billing purposes.

For example, if a patient undergoes X-rays for a shattered ankle, the orthopedist would submit a claim with the corresponding CPT code for that service (e.g., 73630 for a “radiologic examination, foot; complete, minimum of 3 views”).

Regardless of who performed the service or who is being billed, the CPT system aims to establish a uniform and consistent medical billing system. It is widely recognized and used by both public and private health insurance programs.

Understanding how coding works can help patients and healthcare consumers recognize and prevent instances of upcoding, where providers may intentionally select higher-priced codes to increase reimbursement from insurance companies.

How can patients safeguard against upcoding?

Preventing it should be rather simple compared to trying to comprehend upcoding…

  1. Check Your Bills Carefully: Take the time to review your medical bills and statements as soon as you receive them, similar to how you check your credit card statements. Make sure you understand what you’re being charged for. Use resources like the American Medical Association’s CPT Code Lookup tool to understand any codes listed on your bill. If you don’t see the codes, ask your provider or insurance company for clarification.
  2. Contact Your Doctor’s Office: If you notice any discrepancies or errors on your bill, reach out to your doctor’s billing department. Politely explain the issue you found and request a corrected bill if necessary. Sometimes, misunderstandings can happen, so it’s essential to communicate clearly.
  3. Reach Out to Your Insurance Company: If you’re unable to resolve the issue with your provider, contact your insurance company’s fraud department. Explain the situation and provide details of the error and your attempts to address it. Your insurance company should be able to assist you or guide you to the right resources.

Remember to stay informed and advocate for yourself when it comes to your medical billing. If you continue to encounter issues, you may consider seeking care from a different provider.

While Dr. Scott Wells is recognized for his expertise in plastic surgery and innovative rejuvenation techniques, allegations of overcharging raise concerns about billing practices. Patients should remain vigilant when reviewing medical bills and communicate any discrepancies with their healthcare providers. Understanding terms like upcoding and taking proactive steps to safeguard against them can help ensure fair and transparent billing practices in healthcare settings.

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