Multimedia Professional
Apr 16

How to Fight Medical Fraud: Medical Insurance Fraud, Part III

Dancing with crooks

Now that you recognize the many faces of medical insurance fraud and why you should care, our Asurea Scam Report wants to teach you how to dance with these crooks. It’s the last thing a crook expects!

Of course, we are trying to teach you their tricky moves so that you will be protected—now and in the future—from the scams they’re running. The Coalition Against Insurance Fraud has compiled this list so you can learn how to easily fight medical fraud.

Show off your best moves

You probably do most of these already in an effort to protect yourself from medical insurance fraud. But if stopping crooks from dancing circles around innocent people was a piece of cake, we would have nipped the problem in the bud long ago.

Insurance fraud is a centuries-old problem that we will unfortunately always need to fight against. So, you should keep doing everything you’ve been doing to protect yourself against fraud, and you should also take note of these extra tips just to make sure you’ve covered all your bases.

Tips:

  • Keep detailed records of the treatments you receive. Take note of the dates, places, provider information, the services you received, prescriptions or medicines administered (and their doses).
  • Take note of the treatment dates, doctor names, facility location and medical services on the billing and summary statements you receive after each treatment. Even if you think there’s a perfectly good explanation for any discrepancies, follow up with a phone call to your insurance provider or hospital to get an explanation that makes sense.
  • Ask your medical providers how much they charge, and what you’ll pay out-of-pocket.
  • Ignore door-to-door or telephone salespeople offering free medical services or devices.
  • Never give strangers your policy number, insurance ID number or Medicare claim number, especially if they’re offering free gifts, treatments, equipment or cash. It’s probably a bribe.
  • Know what your medical benefits are — what is and isn’t covered.
  • If someone says they can bill your health program to pay for equipment or an uncovered treatment, you’re being swindled. You could lose your health coverage, be arrested, fined, jailed, or end up with a record that could disrupt your life for years to come.
  • Never pay cash for your health premiums, and be suspicious if the health insurer who asks you to pay a full year’s premium upfront.
  • Check with your state insurance department to ensure the health insurance company is licensed to provide services in your state.

Last Dance

The last dance-move is to check if your health insurer has a history of consumer complaints, fraud convictions, or bankruptcies. Start with your state fraud bureau, consumer protection agency and the Better Business Bureau. If you think you’ve been ripped off, you’ll want to contact the insurer that paid the claim.

If you think the scam targets Medicare, Medicaid or other public health programs, then call the U.S. Department of Health and Human Services at (800) 447-8477; write to them at Office of Inspector General, Dept. of Health and Human Services, Attention: HOTLINE, 330 Independence Avenue, SW, Washington, DC 20201; or email them at HTIPS@os.dhhs.gov.

About the Author:
Angela J. Bass is a multimedia journalist from Oakland, California.


Sorry, the comment form is closed at this time.