Los Gatos Urgent Care clinic charged with insurance fraud

Santa Clara County prosecutors have accused the married owner and manager of the Los Gatos Urgent Care Clinic of “massively” overbilling their clients, and Tuesday the couple was formally charged on felony fraud charges.

Dr. Farzaneh Tabrizi, 50, and Ali Moayed, 53, of Monte Sereno, were charged with eight felony counts related to accusations of filing false insurance claims, the Santa Clara County District Attorney’s Office said in a release. If convicted, the couple could be ordered to pay back tens of thousands of dollars in restitution and do time in jail, prosecutors said.

The charges were filed following an investigation by the district attorney’s office that was sparked by complaints against the urgent care clinic, located at 16400 Lark Avenue. One audit of the business “revealed a 100 percent error rate for billing, including ‘up-coding’ – falsely claiming a more serious injury or illness – and billing for services not rendered,” prosecutors said.

James Dunn, an attorney representing Dr. Tabrizi, said “we started to go through these allegations, and it appears we can show these are totally false.”

“We’re very confident we can show these are unfounded,” Dunn said.

Dunn added that Dr. Tabrizi remains focused “on the patients and making sure that they get the best care that she can provide.”

Richard Pointer, an attorney representing Moayed (according to court records), could not immediately be reached for comment Thursday.

Prosecutors said in one case, a patient who stepped on a sea urchin was billed $700 for a pair of foam slippers worth less than $10.

A bio page for Dr. Tabrizi on the Los Gatos Urgent Care Clinic’s website indicates she attended Monta Vista High School in Cupertino, graduated from UC Berkeley and completed her emergency medicine training at Johns Hopkins University.

The Medical Board of California’s website indicates Tabrizi is a licensed physician and surgeon.

Prosecutors also claim patients were billed for diagnostic testing they did not receive.

In one case, a patient went to the clinic to be drug tested for a new job. Even though the patient’s company paid for the testing, the clinic illegally charged her a co-pay and her insurance company $425 for a non-existent urinary tract infection, prosecutors said.

“People go to medical clinics to get care, not conned,” prosecutor Julie Sousa said in statement released by the district attorney’s office. “The District Attorney’s Office has no tolerance for those in the medical care profession who take advantage of ill and injured clients to defraud them and their insurance companies.”

One of the defrauded insurance companies estimated their loss from Los Gatos Urgent Care’s fraudulent practice at more than $200,000.

Source: mercurynews
Los Gatos Urgent Care clinic charged with insurance fraud