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Health insurance scammers

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21 July 2019, 06:33 PM
wtg
Health insurance scammers
quote:
Health insurers are regarded as fierce defenders of health care dollars. But the case of David Williams shows one reason America’s health care costs continue to rise. The personal trainer spent years posing as a doctor and billing the nation’s top insurers, making off with millions.


https://www.propublica.org/art...illions-who-pays-you


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We are all visitors to this time, this place. We are just passing through. Our purpose here is to observe, to learn, to grow, to love… and then we return home. - Australian Aboriginal proverb

Bazootiehead-in-training



21 July 2019, 06:43 PM
CHAS
Not surprising. Worried about corruption in a single-payer system? Take a look at the private system.


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Several people have eaten my cooking and survived.

21 July 2019, 08:27 PM
Nina
Absolutely. I have a relative that works in a business supporting heathcare software. He says that the folks that enter your billing data are barely high school graduates, and the error rate is extreme. But who of us would know enough to catch that? What I see from my insurance about coverage can list doctors I've never heard of (in the case of lab procedures, etc.), services that were rendered for procedures that happened 6 months ago, etc., etc. I'm not particularly stupid, but no way could I audit my health insurance receipts unless I made it a full-time job with spreadsheets, dates, diagnostic codes, etc.

The system is insane.
21 July 2019, 08:32 PM
QuirtEvans
In a recent instance, the insurance company denied a claim, so I called the doctor's office to pay it.

The accounting person in the doctor's office told me NOT to pay the doctor's bill. She said, call the insurance company back, and give them this particular speech, using these particular phrases. They'll review the claim and reverse the denial, although it may take a few weeks. I asked if she wanted me to pay and then send me a check once the payment was processed, and she said no, it was easier just to wait for the insurance company to pay, and she was confident they would.

It reminded me of that scene from The Incredibles.

Lo and behold ...