Medical privacy is a complicated issue, but I'm willing to bet you know a few of the questions that need to be asked before you take your next trip to the doctor. Preventing medical fraud is something almost everyone would like to do, but most people are unaware of the issues that go into it. That's why in this post I will give you some answers on what it is and where it comes from. This is the second installment in a series that will examine the perils of open medical records, and the many dangers of its lack. I hope you enjoyed part 1 and will continue on for this follow-up post. Medical fraud is something that hurts us all. It's not just limited to those who have insurance or apply for it, but also affects those who have no intention of ever going to a doctor to have some kind of treatment.
What is medical fraud?
Medical fraud is defined as the use, or intended use of someone else's health insurance credentials in order to gain from healthcare costs. It can include things like unauthorized use of services, forged documents, stealing or duplicating vital documents and lying on applications. Medical fraud is a serious problem that affects the treatment, raising costs of health insurance premiums and eventually affecting the cost that everyone else pays.
What types of medical Fraud are there?
There are few different types of different medical frauds that we have to be aware of:
Identity Theft – This type is what most people think when they hear the term "medical fraud". It's when someone uses another person's insurance in an attempt to receive a product or service at a lower cost or no cost at all. Most people think this means stealing someone's driver's license and social security number and using it.
Healthcare Fraud – This is similar to identity theft. It's when you give someone your personal information or health insurance records in hopes that they can get billed right away at a reduced price.
Medical Insurance Fraud – This occurs when someone gets a false bill and uses someone else's insurance for treatment. This fraud can come about due to fake medical care that is paid for by someone else. It's usually a lot of money in an attempt to get rich quickly, but it's almost always found out and punished very quickly.
What are the penalties?
Many people may not know what happens when they are caught doing medical fraud or how they are punished. They may be afraid of the consequences, but they don't realize how much worse it can get if it goes on unnoticed. According to the Federal Bureau of Investigation (FBI), "There is no honor among thieves".
How is medical fraud tracked?
Medical records are extremely valuable to many people out there, especially medical professionals and insurance providers. This makes medical records very attractive to those with criminal intentions. In an effort to protect patients, the government has a process set in place that allows information on anyone who tries to defraud hospitals, doctors or insurance companies. Information from multiple sources are used to check for any inaccuracies of all the information that is given in relation to each claim.
What should I do if I'm trying to catch someone doing medical fraud?
First, you need to try and limit the risk of becoming a victim yourself. Do not give out any of your personal information to anyone who is claiming to sell you insurance and try not to sign any documents if they are asking you to. Also, if you have signed something in the past, make sure that it's real and that the form has been properly filled out.
Conclusion
Medical fraud is a serious problem that has been rising steadily over the years. It's important to use proper precautions as well as read each form carefully if you are ever in doubt. Knowing what to look for can save you from much trouble down the road and allow you to take advantage of all the services of your favorite medical professional.
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