Health Insurance Fraud....

By: Taylor


With the advent of new technological reforms related to new healthcare reforms a sudden surge in health insurance fraud has also been reported. The State and Federal health insurance regulators are also warning against such healthcare-related scams. A survey conducted in October 2009 showed that there was higher number of health insurance fraud in 2009 compared to the previous year. Another study, the 2010 Identity Fraud Survey Report, showed that there was a higher incidence of identity fraud compared to previous year. Identity theft or fraud is such a case when someone impersonates someone else at a hospital or doctor’s office. They do it by using stolen health insurance card or account number or other personal information.

This identity fraud has picked up largely due to more easily accessible electronic forms used by medical care providers for record keeping and the large number of people unable to get health care coverage. These thieves use technology to steal information through these easily accessible records, which were meant to make insurance process easy but are misused to do health insurance scams.

This fraud is a relatively new type of fraud thus tapping it or preventing it is not so easy. If someone is a victim of such a fraud then filing a police report and contacting the medical provider and insurance company in writing is the best way to deal with it. The victim should inform the insurance company with details of fraudulent bill for services he had not used and should also attach a copy of the police report.

New healthcare reform bill has quickly sparked new scams. It triggered alertness and the US Department of Health and Human Services issued a warning to consumers to beware of health insurance claiming to be part of new federal regulations. Many frauds use new regulations to fool customers. They offer new health insurance claiming that they are according to new regulation and then run away with all the money they get from customers. It’s better to take precautions before buying a health insurance than being a victim of health insurance fraud. Consumers should also safeguard their health insurance card or other personal information. Medical providers should also be careful with their records to prevent any leak of information.

The consumer can take following points into consideration while buying a health insurance.

Many fraud insurance companies use names similar to a trusted company. So it is better to be not confused and be confirmed that this is the right and trusted company before buying a health insurance.
The consumer should check out about the insurer through all available resources. They should check that if there is any complaint against the company or there has been any government actions brought against company.
Each state has an insurance regulation department which takes care of regulating insurance companies. Consumers should check that the insurer is licensed in its state of operation before buying a health insurance.
Some consumers misunderstand medical discount cards as health insurance. A medical discount card could only be used to get reduced rates at limited doctor’s offices and pharmacies. They are not health insurance, so if one is intended to buy health insurance, he or she should not buy medical discount card instead.
Consumers should check that all the commitments are in the fine print as verbal commitments have no legal sanctity.

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