By Olga Khabinskay, Director of Operations, WCH
Ask most billing professionals where fraud begins and error ends, and the answer comes quickly: fraud is intentional, errors are not. The distinction feels obvious. It is also incomplete — and that gap between the intuitive answer and the legal reality is where a surprising number of organizations find themselves in trouble.
Understanding where the line actually falls is not an academic exercise. It is a practical compliance skill. And it starts with recognizing that the word “intentional” does not appear in the statute most likely to govern the consequences.
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