Monday, September 9, 2013

Common Fraud Schemes (Pt 5)

Health Care Fraud 


Health Care Fraud is an extremely common type of fraud.  It is often perpetrated behind the scenes so you may never even be aware that fraud is associated with your medical accounts but there are still things you can do to help insure that the risk of fraud is minimized.
Medical Equipment Fraud - Free products are offered to the individual, their insurance company is charged and the product is not delivered or was never needed in the first place.  Sometimes you will never even be aware that your insurance company has been billed.

Rolling Lab Schemes - Unneeded or fake tests are given to individuals and their insurance companies are billed.  These look like great opportunities to have tests performed at low or no copay or deductibles; however, the results may be false or you may never receive the results at all.

Medicare Fraud - Doctor’s signatures are often forged to order equipment or tests that are not needed and Medicare is then billed for the unneeded items.  Again, you may not even be aware that the equipment and tests have been billed for.

To help avoid falling victim to any of these health-care related frauds, follow these simple tips:
  • Don’t sign blank insurance forms.
  • Don’t allow a provider to have a blanket authorization to bill for services.
  • Don’t give your insurance information to someone you are not familiar with.
  • Check into any companies offering “free” or low cost testing.  Better Business Bureau is a great place to start.
This is the fifth in a series of blogs about types of fraud which are frequently seen in today’s world.  In our next posting, we will discuss Strawman, Redemption or Bond Fraud Schemes.  Always stay alert and if you are unsure about something you’ve been offered, we’d be happy to help you determine if the opportunity being presented to you is in fact legitimate.  It’s far better to be safe than sorry!  916-576-7050.

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