Tuesday, 30 July 2013

Posted by WESTHILLINSURANCE - Westhill Consulting Insurance - How to Avoid Health Care Fraud

WesthillConsultingInsurance - Howto Avoid Health Care Fraud


Patients who buy drugs through mail-order companies could be rolling the dice with their health says Dr. Deborah C. Peel, a physician and founder of the nonprofit Patient Privacy Rights.  There’s a high probability in many cases that these drugs are counterfeit Peel added.
“And you don’t ever know because the fraudulent tablets look just like the real ones,” says Peel.
She says ordering from companies that specialize in mail-order sales that are not affiliated with a legitimate insurance company, especially from foreign countries, can be very risky. Not only could the quality be questionable, it could also be illegal.
“But people are desperate because we’re being so grossly overcharged for medication,” she says.
Peel says you can lessen costs by buying generic. You can spot it by: the best thing to do is to keep away from buying drugs from foreign or obscure pharmacies.  And if you decide to go with the mail-order route, just stay with U.S.-based companies because if it’s a U.S. company, you can report the health care fraud to the Food and Drug Administration while if it’s a foreign company, there’s little that can or will be done.

According to the Federal Trade Commission, millions fall victim each year to false miracle cures. Especially vulnerable are victims of debilitating and potentially deadly illnesses such as cancer, multiple sclerosis, HIV and AIDS.
The FTC website says scammers take advantage of people with a grim diagnosis such as cancer and “promote unproven — and potentially dangerous — substances like black salve, essiac tea, or laetrile with claims that the products are both ‘natural’ and effective.” But, say physicians and other experts, simply because something is advertised as “natural” doesn’t mean it works. And while a patient is experimenting with bogus treatments, he or she can squander the opportunity to receive treatments that might truly be effective. Peel says consumers should beware of products with personal testimonies that prove nothing. Don’t trust a product just because of favorable reviews on the Internet, she warns.

How to spot it: If product claims make it sound like it’s too good to be true, then it is. Something that works miracles would make headlines, so when “Mary in Indiana” says that a special tea cured her cancer, it’s a worthless testimonial.
Here is something worth doing: protect yourself against phony products through talking to your trusted physician or physical therapist.

Dental treatments performed by nonprofessionals

Earlier this year, an Oklahoma dentist accused of allowing unlicensed employees to give IVs to patients made nationwide headlines after some patients were alleged to have contracted hepatitis due to the purported use of contaminated instruments.
This happens although not that usual, and industry professionals such as James Quiggle, communications director of the Coalition Against Insurance Fraud, say you can take steps to ascertain that your dentist employs ethical practices. One such step is to scope out dentists you’re considering.
“Go to two or three dental offices and get a sense of the comfort level of that office, how clean it is, how professional and whether it’s up-to-date and well-lit,” says Quiggle. While dental scams are not as common as some other types of health care fraud, the results obtained by an unscrupulous dentist can be life-altering in a terrible way.
Trust your instincts and find someone else: if you have dental insurance, check your explanation of benefits statement and make sure it matches the work you had performed.  If the office seems unsanitary or the staff not properly trained, better be a sign of not pursuing to have any transaction with them.

A report from Ohio authorities said they’ve indicted a man for using a fraudulent identity to obtain $345,000 in medical treatment from The Ohio State University Wexner Medical Center.  The man used a stolen license multiple times in order to get services from 2008 to 2013, according to news media reports.
Medical identity theft is one of the most serious and fastest-growing crimes in the nation.  Some sources say the damages run as high as $234 billion.  Some 1.85 million Americans were affected by medical identity theft in 2012, according to a study by the Ponemon Institute.
Jeff Young, vice president of fraud control at Verisk Health, says you should guard your health care insurance information as carefully as you do banking data. “Protect it, don’t carry it around and report it immediately if you lose it,” says Young.
Your credit can be ruined if you become the victim of medical ID theft.  You can find flawed treatment information on your records and creditors will harass you to pay for treatment never received.

Bogus medical treatment after a staged car crash

Quiggle says it’s an old scam he’s seeing more and more, as well as a source of rising insurance premiums.  Four residents of Jacksonville, Fla., including a chiropractor, were recently arrested and charged with staging automobile accidents, then steering the victims to the chiropractor for treatment they did not need.
Fake accidents are very common and more often than not dangerous.  The National Insurance Crime Bureau reports that criminals targeting the Las Vegas area are staging fake accidents by pulling into the paths of big rigs and slamming on their brakes.  These scammers are up to getting big settlements out of the truckers but a lot of these staged crimes also involve false medical treatment.