Healthcare Fraud

Most popular health care frauds

Health care employees are looked at as one of the noblest people by many. But don’t be fooled. Even though many of the medical providers are honest and do a good job in improving our health, there are still the ones that are looking at us through the eyes of fraudsters, and they are just waiting for the opportunity to get their hands on some free money, where we, and our health problems represent the perfect means. Fraud in health care is just like in any other industry: Fraudsters with the means and opportunity take full advantage to unjustly profit. Health care crooks inside and outside the industry include patients, payers, employers, vendors and suppliers, and providers, including pharmacists. Organized crime rings and computer hackers also play roles in committing health care fraud. What are some of the most popular health care frauds? Find out in the following!

Change the code and non-covered service becomes covered

Charging non covered services as covered services is one of the most common frauds in health care. Here is how it plays of. Say an allergy doctor wants to treat his patients with an experimental drug that hasn’t been approved by government health care plans or other insurance companies. With just a few strokes of pen the allergy doctor can submit claim forms and still get paid for utilizing the experimental treatment. It is that simple, the doctor can just code the drug differently and call it something else that is covered by insurance plans and policies. The doctors who get caught rationalize their wrongful actions by saying they believed they were providing a useful service to their patients who were actually their guinea pigs that helped them in testing new and unapproved drugs that could cause lots more damage than good.

Your insurance pays for something you do yourself

Health care fraudsters go as far as misrepresenting locations of service. In one clinic, during the period of treatment, the patients were given a bunch of syringes filled with antigens and they were told to inject it themselves in their homes. Now, as horrible as this sounds, it is nothing uncommon. The uncommon thing is that health care providers in this clinic billed the service of injecting those syringes themselves to the insurance companies of their patients. They were just submitting claim forms on injecting their patients with the antigens from Monday through Friday in the clinic facilities. Besides billing for the service they haven’t done, this way they protected themselves with the medical files in case if the patient forgets to inject himself and the treatment fails so he decides to sue them.

Severe diagnosis for a bigger bill

Listing an incorrect diagnosis or procedure can be compared to a scheme in a repair industry of any kind. Say if you go to an auto repair shop, you must know that simple change of oil in your car is much less expensive then the complete car check up. Unscrupulous providers can bill for extra services if they report false serious diagnoses or procedures performed. For example, if an elderly patient reportedly fell inside a nursing home, a crooked provider could intentionally misdiagnose her with head trauma requiring the (unnecessary) use of a computed tomography (CT) scan and/or blood tests. This example is just a mild one of what is being done. Some diagnoses require longer, more expensive hospital stays. There are numerous examples of patients who suddenly and mysteriously got better as soon as their insurance coverage ran out. We have only listed three of some of the most common frauds in health care industry, but like in all spheres of life, there are so many more. The important thing is to recognize them and not get scammed. The scheme descriptions in this article will get you started in learning how to battle this scourge, help victims and reduce soaring health care costs.

Charity Fraud

Check before you donate! Dont be the victim of Fraud!

It really is heartwarming to give away some of your money and goods to those less fortunate. Fortunately, many people like to give with an open heart to help others in need. Still, you have to be aware! Unfortunately, we’ve created a climate that's ripe for fake charity scams and scam artists. They know they can tug at our heartstrings -- and rake in the cash. From all of our articles, you could learn that fraudsters are heartless criminals always praying on the weak ones. Lately, there has been a large increase in charity frauds. So, if you’re considering a request for a donation to a charity, do some research before you give. We are going to try and help you through the following article as much as we can with the signs through which you can recognize if the charity is a real one or a fake one. By finding out as much as you can about the charity, you can avoid fraudsters who try to take advantage of your generosity. Here are tips to help make sure your charitable contributions are put to good use.

How to recognize a fake charity

Fake charities aren’t always easy to spot. They are often “packed” in seemingly legitimate agencies, so they look pretty real. They may even carry 'ID' in the name of the charity, complete with a logo. These scam artists use all of the standard methods to collect 'donations' for their charity fraud -- tables at the local mall, going door-to-door, email, and telemarketing. All this makes charity scams harder to spot. However, here are 8 tips to help spot charity scams: 1. Be cautious of every opportunity that presents itself in the wake of some big disaster that gets a lot of media time. 2. ALWAYS ask for the name, address, and phone number of the charity -- and whether or not it is registered. If the presenters claim that it is registered, get a registration number. 3. Verify with the office of the charity that there is indeed a campaign going on, or that they've authorized the charity drive that you're being invited to contribute to. 4. Don't ever donate cash if you can help it. Write a check to the charity -- not to the person standing in front of you. This also helps you document the donation for your records and for your tax return. And don't give out bank information! 5. Ask what percentage of your donation goes directly to the cause. Legitimate charities will have ready answers because they are used to the question. 6. Get a receipt with the name of the charity on it. 7. Be especially cautious about getting a charity donation request by email. Most legitimate charities don't use email for their solicitations. 8. Be especially wary about charities that claim to be raising funds for the local police or firefighters. Check with them first! 9. Read up on the latest scams and fraud, be aware of how criminals are trying to take your money. Don't give in to pressure or guilt trips about “suggested donations” or “requested minimum contributions.” Once you've determined that the charity is legitimate and you've decided you want to contribute, simply give what you can and want to give -- it will be appreciated. What you should avoid These days, charities and fundraisers (groups that solicit funds on behalf of organizations) use the phone, face-to-face contact, email, the internet (including social networking sites), and mobile devices to solicit and obtain donations. Naturally, scammers use these same methods to take advantage of your goodwill. Regardless of how they reach you, avoid any charity or fundraiser that: Won’t give you detailed information about its identity, mission, costs, and how the donation will be used. Won't give you receipt so your cash donation can be tax deductible. Uses a name that closely resembles that of a better-known, reputable organization. Thanks you for a pledge you don’t remember making. Uses high-pressure tactics like trying to get you to donate immediately, without giving you time to think about it and do your research. Asks for donations in cash or asks you to wire money. Offers to send a courier or overnight delivery service to collect the donation immediately. Guarantees sweepstakes winnings in exchange for a contribution. By law, you never have to give a donation to be eligible to win a sweepstakes. Writing about this subject is very delicate matter, and one always worries that it is going to affect on people donating less. We are in no way promoting that, we are just saying you should be more careful with your donations, and you should make sure that they end up where you intended them to end up, and not in the hands of fraudsters.