Fighting Back Against Medical Fraud

Over the past few weeks,I have interviewed national experts on a growing area of concern for seniors, medical fraud. There are several aspects regarding this issue that are important for you to know about. My hope is that they will help prevent you, or someone you love from becoming a victim.

Medical Identity theft This is one of the fastest growing areas of criminal activity in the medical area. It begins with someone gaining access to your ID number, your medical ID card, or your medical record. They then present your personal information, at a clinic or hospital, purporting to be you. Finally, they receive the care or treatment needed and skip out without paying. Of course, the final result of this unethical behavior leaves you stuck paying a bill, for services you never received. It only gets worse from there, because their medical information goes onto your record. So, if at a later date you are brought to the hospital, and incapable of speaking for your self, this would spell disaster. Not only could you potentially get administered the wrong blood type, but they could mistakenly pump you full of a medicine you were allergic to. The lesson is: treat your medical information and your medical ID data as highly valuable and confidential. Also, keep tabs on your credit report to see if a hospital or clinic is saying you haven’t paid for care that you never received.

Unnecessary medical procedures Believe it or not, there are some unscrupulous, licensed healthcare professionals who perform unnecessary major medical procedures. They are knowingly aware that you don’t need them, but insist on the surgery. Yes, they perform procedures on healthy people just to get the money from health insurance or Medicare. ALWAYS get a second opinion from a physician in another practice, before you have a non-emergency surgery or other major procedure.

Health Insurance Fraud Many seniors seek supplemental coverage to what Medicare provides. Don’t be fooled by those nice people on TV ads. The TV networks do not do a great job of checking to see if the advertiser is a legitimate company. From what I’m hearing, these scam artists have become very slick. Too often people call an 800 number, or go to a website to sign up. They send in their premiums for several months, but when they need coverage the company has either disappeared or fails to provide service. To avoid this, check with reputable agents and name companies. By the way, the scam artists love to pick company names that sound reliable, or even like the government. Do not be fooled!

Seniors naturally have the greatest medical needs, which also can make them the most vulnerable. We’d like to believe the younger people who offer to help are always well meaning, but sadly many are not. Among them are outright criminals who do not care if you are harmed, and are only after your money.

One of the best allies in your effort to fight back is your state insurance commissioner’s office. If you have a concern, give them a call. If you are interested in hearing my interviews on medical fraud just go to: www. patientpower. info/specialeditionfraud. asp, and search under program replays and Health Topics for “medical fraud.”

Remember, knowledge can be the best medicine of all!