Tagged: insurance fraud Toggle Comment Threads | Keyboard Shortcuts

  • Geebo 8:00 am on May 26, 2023 Permalink | Reply
    Tags: , , insurance fraud, ,   

    Scammers try last-minute Medicare fraud 

    By Greg Collier

    If you are a Medicare recipient and have recently received COVID tests you didn’t order, you might be the victim of Medicare fraud. With the Public Health Emergency around COVID being declared over this month, scammers have been sending COVID tests to Medicare recipients, while billing Medicare at close to $100 a pop. Victims have said they received multiple COVID tests from providers that were outside of their state.

    Now, some Medicare recipients may not think that this is a big deal. They might think they got free COVID tests while Medicare paid for it. So, what’s the big deal? Outside of their Medicare information being compromised, any kind of fraudulent charge billed to Medicare can have negative effects on a policyholder’s benefits.

    If a fraudulent charge goes undetected, the patient may be responsible for paying out-of-pocket for services or supplies they did not receive or need. Medicare has coverage limits for various services and supplies. Fraudulent charges can lead to unnecessary utilization of these benefits, causing patients to exhaust their coverage limits prematurely. If fraudulent claims are submitted using the patient’s Medicare information, it can lead to confusion in medical records and billing systems. This may result in delays, denials, or even the denial of legitimate claims, causing a disruption in the patient’s ongoing care and treatment plans. Lastly, fraudulent claims sent to Medicare increase healthcare costs in general.

    If you receive tests that you didn’t order, contact Medicare immediately at the customer service number on your Medicare card. To help prevent future fraud, policyholders should always review the Explanation of Benefits (EOB) statements they receive in the mail. These statements show how a claim was paid and to whom.

    Any suspicious charges or discrepancies should be reported to Medicare’s fraud hotline, so they can try to rectify the situation. Additionally, staying informed about common fraud schemes and protecting personal Medicare information can help reduce the risk of fraudulent activities.

  • Geebo 8:00 am on October 15, 2021 Permalink | Reply
    Tags: , , , , insurance fraud,   

    Addiction centers are still scamming patients 

    By Greg Collier

    Having a family member with a substance abuse problem is one of the worst experiences in life to go through. Just getting them to admit that they have a problem is a monumental step on the road to recovery. But what then? Some people choose to admit themselves to an addiction center, more commonly known as rehab. But which one? Should they stay local or go to one out of state? Should they go to one of the addiction centers advertised on daytime TV? Well, before you answer any of those questions, you should probably know about how people suffering with addiction are often scammed into entering a fraudulent program.

    Two men from Massachusetts were recently arrested for allegedly committing insurance fraud by recruiting recovering addicts into poorly run addiction centers. The pair is accused of signing up their victims to treatment centers in Florida, where the patients would receive little to no actual treatment. The men are also accused of opening insurance policies in their victims names and collecting kickbacks from the insurance claims the treatment center filed. Sometimes the insurance policies would go unpaid, which would result in the victim being put out on the street hundreds of miles from home. One of the men is even said to have recruited his victims from local recovery meetings in Massachusetts.

    Unfortunately, this is not a new type of scam. These recruiters are known as body brokers and have been doing this for a while. In past instances, some patients were even paid to relapse, so the addiction centers could continue to bill the insurance companies.

    As with any life-changing decision, take the time to do the research on any facilities you or a loved one may be considering. Do a web search with the name of the facility and the word complaint to see how previous patients felt like they were treated. The Better Business Bureau website is also a great resource for trying to separate the scammers from the legitimate facilities.

  • Geebo 8:39 am on May 20, 2020 Permalink | Reply
    Tags: , , insurance fraud, ,   

    COVID test scam targets elderly 

    COVID test scam targets elderly

    During the current crisis, the elderly are not only the most vulnerable to the virus but could also be the most vulnerable to coronavirus related scams. Once again, an old scam has been repurposed for the global pandemic and it involves seniors’ healthcare.

    According to the Better Business Bureau, scammers are posing as Medicare employees offering coronavirus home testing kits. They ask their victims for personal information including seniors’ Medicare information. Tests are sent to the victims but again, no home test has been approved for use by the FDA. The BBB says that these scammers are more than likely committing Medicare fraud and are billing these tests to Medicare. If Medicare is paying the scammers for these tests, this could affect Medicare coverage for future coronavirus testing by doctors.

    If you receive one of these calls or possibly an email from someone claiming to be from Medicare offering you a test kit, either hang up on the call or delete the email. Whatever you do, please do not respond to any of these offers. Keep in mind that if Medicare was actually calling you, they wouldn’t need to ask for your Medicare number.

    This also goes for people on private health insurance as well. Your insurance company isn’t going to offer you an at-home test kit and won’t ask you for your ID number. If your insurance company ever does need to call you, they’ll already have that information on hand.

    Both Medicare and private insurances mostly communicate with patients by postal mail. Anybody claiming to be them with some kind of offer is either an identity thief or an insurance fraudster.

  • Geebo 8:00 am on April 3, 2020 Permalink | Reply
    Tags: , , , , FTC Scam Bingo, insurance fraud, , staged accident   

    Phony relief checks and more coronavirus scams 

    Phony relief checks and more coronavirus scams

    Scams related to the current coronavirus pandemic have not subsided in the least. If anything, they’re ramping up with old scams getting a new coat of paint with a coronavirus slant. Here are some more scams that we have found in the news dealing with covid-19.

    The US Attorney’s Office and the IRS are warning about scams related to the coronavirus relief payments. We’ve already covered some of those scams at this link. More recently, these offices have also mentioned that fake checks may be sent out by scammers designed to look like authentic checks. They warn that fake checks may be made out in an unusual amount. Actual government relief payments should be at a rounded dollar amount and not have any cents in the payment. These phony checks may also ask you to call a number or go to a website to verify the check. This is also a scam designed to steal your personal and financial information. As has been noted previously, most of the relief payments will be deposited directly into your bank account.

    Coronavirus scams have gotten so out of hand that the Federal Trade Commission is asking people to make a game out of it but one that can teach others about the scams. On their website, the FTC has what they’re calling an FTC Scam Bingo Card. They’re asking that if you’ve been approached in one or more of these scams to mark it off on their bingo card and share it to social media using the hashtag #FTCScamBingo. The more people who know about these scams the less likely they are to become a victim.

    A copy of the FTC Scam Bingo Card (click for larger)

    The National Insurance Crime Bureau (NICB) is warning about various insurance frauds related to coronavirus but one particular one caught our eye that is related to social distancing and it’s the staged accident scam. The most common one is known as the ‘Swoop and Squat’. This is when there are a pair of cars and one gets beside you while the other one gets in front of you and stops suddenly causing a rear-end collision. With social distancing and quarantines put in place the scammers are hoping that they’ll be fewer victims for these accidents. The best way to protect yourself against these scammers is to get a dashboard camera and to always get the police involved in any vehicular collision that warrants it.

    [youtube https://www.youtube.com/watch?v=rNe0IkG_ARk%5D

    If you see a coronavirus testing site that has popped up overnight, it may not be legitimate. The City of Louisville, Kentucky recently had to deal with three popup testing sites that the city classified as scams. These testing sites were not working with the state and could have potentially been committing health insurance fraud. If you see one of these testing sites, contact your local city government to see if they’re legitimate or not.

    Lastly, in South Carolina college students were contacted and asked to take place in a vaccine trial for the coronavirus. While pharmaceutical trials are a real procedure done in conjunction with medical facilities, there are currently no trials going on for a coronavirus vaccine. We imagine this may have been another scam designed to steal personal information.

    Again, we’d like to remind you that this has been a boom period for scammers. Please don’t let the fears surrounding coronavirus push you into making bad decisions that you’ll regret later.

Compose new post
Next post/Next comment
Previous post/Previous comment
Show/Hide comments
Go to top
Go to login
Show/Hide help
shift + esc