When No One’s Watching: The Test of Barakah-Aligned Billing

As-salamu alaykum,

It was supposed to be a routine telemedicine consult.

A complex patient with multiple comorbidities and enough problems, data points to review and risk for complications that under normal circumstances, would have easily qualified as a level 4 billable encounter.

But then the video wouldn’t connect.

I tried troubleshooting. Switching devices. Calling back. Nothing worked.

Eventually, I had to make a choice—not about the technology, but about what kind of clinician I would be at that moment.

Would I keep troubleshooting and holding on to the possibility of a meaningful video encounter—a billable event—and inadvertently delay care in a mindless moment,  or move forward without the ability to see the patient but address the concerns as best as I could over the phone?

Alhamdulillah, I chose to proceed over the phone.

I did the evaluation—without video. And ended up recommending a prompt transfer to the ED. I called the ED and handed off the patient’s care. I completed my documentation. And I walked away from the case thankful for an impactful clinical encounter.

I also entertained a transient thought about the zero billable value—but Alhamdulillah, moved on with peace of mind knowing that the tangible “rizq” was not written for me in this case—but that in sha Allah, the reward for the care was.

Because here's the truth:

The patient was served. The system won’t compensate. But Allah sees it all.

Divine Wisdom: Mutaffifin in Healthcare

Allah begins Surat al-Mutaffifin with a scathing warning:

"Woe to those who give less [than due], who, when they take a measure from people, take in full. But when they give by measure or by weight to them, they cause loss. Do such people not think that they will be resurrected, for a tremendous Day—the Day all people will stand before the Lord of all the Worlds?"
 (Surat al-Mutaffifin, 83:1–6)

These profound words carry immense weight tied to business ethics and professional integrity for us as healthcare professionals who may be shortchanging our patients and clients—even in subtle ways. 

Allah, the Most High, nudges us to wake up to the reality of divine accountability! 

That we cannot simply treat these transactions as merely worldly pursuits but rather—engagements that have long-term ramifications in this life (diminishing barakah in our rizq) and more importantly, our eternal success in the hereafter.

Integrity is the Hidden Weight of Our Work

In recent weeks, we saw the U.S. Department of Justice 2025 National Health Care Fraud Take Down report making rounds—the report had names of colleagues from diverse backgrounds but the Muslim-sounding ones caught the attention of our community. It was a sad moment. 

It shook me. It still does.

Not because I believe we’re immune to error.

But because it reminded me that one subtle decision at a time—justifying shortcuts, bending rules, “getting what we deserve” etc. can lead to consequences far beyond that encounter, that moment, or even that role.

As Muslim healthcare professionals, we carry both the privilege and the burden of double accountability.

• To the state and the system.

• And to Allah, Al-Baseer, the All-Seeing.

The DOJ Report is a reminder to “Choose Wisely” in these crucial moments. To choose Allah’s way and attract Barakah. 

Consider the following;

1. Billing with Barakah is a spiritually-intelligent decision, not just a financial one.
   Your niyyah (intention) matters. Your process matters. Even if you’re the only one who seemingly knows.
   

2. Patient outcomes must always override personal outcomes. That is Ihsan
   It was tempting to troubleshoot longer—hopefully with the intent to provide better care and not just to get to the bill. But time is of the essence in healthcare—and patient safety and outcomes are an Amanah. So we proceed mindfully in a manner that will best serve the patient in the situation.
   

3. Not every rizq is written for me and you.
   Alhamdulillah. I walked away with no RVUs. But also with no regret. 

A Call to Reflect—Individually and Collectively

If you’re in a moment of moral friction around documentation or billing, ask yourself:

• Would I still approach things this way if an auditor was watching?

• Would I still do this knowing that Allah, Al-Baseer (the All-seeing) is always watching?

• Would I be able to stand by these actions on the Day of Judgment?

If you’re a team leader or practice owner:

• Are you creating a culture where values > volume?

• Do your colleagues and staff feel safe raising red flags?

• Do you have a system for staying grounded in your ethical standards as a team?

• better from your closest family and friends to colleagues at work.

Dear colleagues, the pursuit of professional and financial success in our roles is one that must be approached with Barakah-aligned clarity driven by well grounded spiritual intelligence in healthcare. 

The ramifications transcend our day-to-day interactions with patients and families. Rather, this pursuit can be incredibly meaningful for our patients, their families, and the healthcare system on one hand—and transformational for us if approached with the ethos of spiritual intelligence in healthcare that keeps us anchored to Allah’s will, attracts barakah to our work and our lives and renews our purpose and commitment to the service of humanity.

May Allah, the Most High, bless us with halal sustenance, and continue to assist us on this journey of transformation surrounded by enablers who nudge us to always be seeking our next best versions on our journey to Allah. Amin

Sincerely,
Sulyman

P.S. If you’re seeking a space to cultivate resilience, deepen self-mastery, and thrive in your career and life—grounded in faith—join us in the SakeenahMD Community. Together, we are committed to faith-driven excellence in healthcare and beyond.

Let’s navigate this journey together. 💙