3 Common Health Care Frauds & Tips to Avoid Them
Scams are widespread in our society, and nowhere is it more common than in the health care industry. Medicare and health insurance fraud is a major problem and it costs everyone. The FBI lists health care fraud as one of the most prevalent scams affecting senior citizens. Many senior citizens on fixed incomes rely on their Medicare and supplemental health insurance. Sadly, that is where many of the elder fraud scams originate. You can avoid these scams by recognizing them for what they are, and you can save yourself anxiety and money.
Some Common Health Care Frauds
#1 Medical Equipment Fraud: One common fraud is known as Medical Equipment Fraud. Some dishonest medical equipment businesses target seniors by offering free products to individuals. This is a fraud because a doctor must order and sign for all materials or equipment before Medicare will pay for it. Insurers are then charged for products that were not needed and/or may not have been delivered.
A doctor must sign forms authorizing that equipment or certain tests are needed before Medicare will pay, but some con artists phony signatures or bribe dishonest physicians to sign the forms. Once the signature is secured, the disreputable company bills Medicare for goods or services that were not ordered or, in many cases, not even needed.
#2 Rolling Lab Scam: Another scheme by fraudulent medical providers is known as a “Rolling Lab” Scam. Fake tests or unnecessary procedures are sometimes given to individuals at health clubs, retirement homes, or shopping malls and billed to insurance companies or Medicare. Never sign a blank insurance claim form and never authorize (for billing purposes) a medical procedure not provided.
Sometimes services are not provided at all. Always review Medicare’s payment terms closely and never give out your Medicare numbers to someone you don’t know. Medicare fraud takes many forms and senior citizens are often the target of Medicare scams.
#3 Counterfeit Prescription Drugs: Although not as common, counterfeit prescription drugs are another health fraud to avoid. Be careful when you purchase drugs over the internet. Always make sure you are dealing with a licensed online distributor. Do not purchase medications from those who sell them without a prescription. Consult your doctor or pharmacist if you suspect your prescription drug has been tampered with. It is looks suspicious or your medication causes any adverse effects, tell him right away.
5 Tips to Avoid Being Scammed
Never sign a blank Medicare claim or insurance form.
Never deal with a telephone or door-to-door salesman who tells you they offer free medical equipment or medical services.
Always review your insurer’s explanation of benefits statement and call your insurer if you have any questions.
Always keep records of your health care appointments and know whether your doctor ordered any tests or equipment for you.
Never give a blank authorization to a medical provider for services and ask if you are expected to pay any out-of-pocket expenses.
Copyright 2012 S. R. Morris
Available for Reprints 