Beware of Healthcare Schemes

Many, including myself, have opined about the problems with health insurance companies, but have failed to notice the enormous harm that healthcare providers are inflicting on the insured, and even the insurance companies. Before last year I had no frame of reference about healthcare abuse as I had not been sick before.

I would like to note that most healthcare providers are honorable people who give their patients the best possible medical care. Healthcare providers are professionals that a person sees for checkups and other health problems. The providers may be medical doctors, nurse practitioners, physical assistants, nurses, from registered to licensed, therapists of all kinds and home care organizations that provide medical equipment.

How did I come to this conclusion? Well, in the last year, I have had to utilize these various healthcare providers. I have found problems from a physician, some therapy organizations and a homecare organization. As I have checked the summaries paid for by my insurance company, I have discovered errors, schemes and possible scams. I found that a physician billed a medical visit (for which I have no recollection) to my insurance company a year and a half after that supposed visit was to have occurred. I have had my copay charged several times by a therapy company. One homecare company has continued to bill my insurance company for medical equipment that was returned six months ago. (Equipment that my insurance company later informed me was supposed to have been rent-to-buy but the homecare company deceptively informed me that it was rental equipment that was to be returned). And, my friends, I have not opened all of my mail from my insurance company yet!

Here Are Ten Common Healthcare Schemes That Will Open Your Eyes Further:

• Billing for services not rendered.
• Billing for a non-covered service.
• Misrepresenting dates of service.
• Misrepresenting locations of service.
• Misrepresenting provider of service.
• Waiving of deductibles and/or co-payments.
• Incorrect reporting of diagnoses or procedures (including unbundling).
• Overutilization of services.
• Corruption (kickback and bribery).
• False or unnecessary issuance of prescription drugs. (www.acfe.com)

Last year, false claims schemes accounted for 25.5 percent of provider fraud cases and usually involved fake medical personal and identity theft. (healthpayerintelligence.com)

We can always learn more, my friends, as I am learning, so open all of your insurance statements and read them thoroughly! It can save your insurance provider, but more importantly, it will save you the consumer. We know this because the excesses and liability costs incurred by insurance companies are always passed on to us, the consumers!

Stay Diligent About Healthcare Costs!