Healthcare Fraud Billing Schemes

I was perviously a Uniform Program Integrity Contractor (UPIC) Investigator with Medicare, and I saw alot of very creative fraudulent billing schemes come across my desk. Without being too specific, here are some tips to help safeguard you Medicare benefits:

1. It appears that immigrants with limited English were targeted more

2. The elderly were also targets

3. It was easy for the billing schemes to work because the victims hardly ever reviewed their EOB

4. It was often too late or past the time-frame to bring action because it took too long to investigate.

Best thing to do is to review all of your Medicare documentation that you receive in the mail. Make sure that the doctor listed is the one that actually serviced you. Contact the Medicare customer service department if you believe that you have have been billed for a service not received. Read more about Healthcare Fraud with this article by the Association of Certified Fraud Examiners on 5 Common Billing Schemes.