Kelly Addam Gersting was a biller for Rehabilitative Mental Health. He was billing for services provided by Ingrid Sanches when Sanchez was traveling outside of Las Vegas and the United States.
The billing scheme occurred for four years between 2015 through 2019. The biller, Mr. Gersting, routinely billed claims when he knew Sanches did not provide the services. This case was brought to the attention of the Medicaid Fraud Control Unit (MFCU) after an employee of Rehabilitative Mental Health filed a complaint.
Mr. Gersting was sentenced to 364 days in jail, suspended, and placed on probation for one year. Mr. Gersting was ordered to pay $42,510 in restitution as part of the sentencing.
Attorney General Ford stated in part, “Billers are key personnel in ensuring the integrity and accuracy of claims submitted by Nevada providers.”
This case is not the first of its kind but a reminder that billers and coders have an obligation to ensure claims coded and billed are accurate and do not become part of a scheme to defraud payers or patients.