A doctor of newborn infants is accused with bilking Highmark BlueShield, Capital Blue Cross and HealthAmerica out of $2 million in falsely reported claims.
Dr. Saroj Kumar Parida, 49, a neonatologist from Manheim Township, Pa., was in a Cumberland County courtroom March 3 to face numerous charges, including three felony counts of insurance fraud, according to a report in the Lancaster Intelligencer Journal.
The charges come after a nine-month investigation by representatives of the three insurers and Cumberland County detectives, which found that Parida allegedly billed the insurance companies for sleep-monitoring services that were never provided.
The investigation began in May 2008, when a Highmark policyholder questioned the doctor’s claims for services from a year earlier. Parida said it was a billing error he had no control over, according to court records.
Highmark then began researching Parida’s other bills and found $600,000 more in payments for allegedly billing for multiple days of interpreting sleep data over a 30-day period despite being allowed only one bill under the insurer’s guidelines. The doctor is also accused of billing for sleep interpretations prior to patient’s births and after monitoring had stopped, the report said.
Capital Blue Cross found another $800,000 in allegedly fraudulent payments from 2005 to 2008, and accused him of falsifying billing records and reporting interpreted data as more comprehensive sleep studies. A subsequent investigation by HealthAmerica found billion of more than $600,000 in similar claims.
An affidavit alleges that Parida has no office or clinic and runs his operation from his home using a pair of aliases as billers.
Parida was released on bail and the native of India had to surrender his passport, according to the report.


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