So what if your provider files false claims on you? Your insurance company will make it right…..right? In healthcare, the written record is the law. So without oversight and review of that record by the patient before claims are submitted, the burden of proof for fraudulent claims is extremely challenging.
Why does this matter to you?
- Every false patient diagnosis remains a part of your documented medical history, at least in the health insurer’s record. You can ask for an appeal or request to send in a note of clarification, but few people know how.
- Victims of medical identify theft could receive the wrong medical treatment or even become uninsurable for life and health insurance coverage depending on what fraudulent notes are included in their record. What is worse, is these victims may never know of these errors or even never know until it is too late.
- You could be subjected to dangerous medical procedures, just for greed.
Tips to avoid being a victim of healthcare fraud:
- Protect your health insurance ID card like you would a credit card.
- Report fraud immediately to your insurance company.
- Be an informed consumer of healthcare. Know what services you have received, keep good records of your medical care and closely review all medical bills you receive.
- Read your health insurance policy and EOB statements.
Yet another example our broken healthcare system: It does not allow the patient to hold the physician accountable for services rendered or review medical notes submitted before insurance issues payment. In my opinion, this must be changed in order to better protect healthcare consumers.
For more information visit:
https://www.nhcaa.org/resources/health-care-anti-fraud-resources/the-challenge-of-health-care-fraud.aspx