Case Study: Dr. Bales

Since I believe Dr. Bales is violating not only an ethical code but also legal laws in the process of falsifying transcription in health records. I feel it would be necessary for me to report my findings to the collections office to let them be aware of fraudulent documentation that is leading to fraudulent charging. Dr. Bales is trying to seek more reimbursement for services he did not provide which is considered theft. The collections office is in charge of sending invoices to insurances companies for reimbursement, which solidify their involvement in the fraudulent actions even if they are unaware. In the event which the insurance companies discover these fraudulent charges, the collections office may face legal repercussions for their participation.
Therefore by informing the collections department of these activities, the ethical code of nonmaleficence is being fulfilled. It is to bring no harm to the collections personnel. It can also be applied to the actual patient that is involved in the fraudulent charges. If the patient is an individual that has multiple health issues that require many services and it just so happens that this fraudulent charge causes him/her to reach the maximum amount which the insurance policy covers. Then the patient has to endure harm by suffering higher insurance premiums or higher out-of-pocket costs. If Dr. Bales has been falsifying documentation to earn higher reimbursement for a long period of time, it could lead to insurance companies increasing premiums to cover the costs. Therefore hurting all policy holders. So reporting the incident would also fulfill the justice ethical principle because it would be providing fairness to all of the policy holders. Overall, the ethical code of beneficence is fulfilled by reporting the incident because it would help others; the policy holders, collections personnel, insurance companies, and Dr. Bales from negative outcomes.