Real time. Too many images selected. But for those who remain on the job, they often won't tell what they know until they're confronted.
I've found it's usually best to interview employees and former employees of medical facilities at their homes or at least away from the facilities. Make sure you leave your business card with them, even if they don't want to talk yet. Billings for services and care not rendered often make for simple cases to present in court because the scheme is so basic that even half-asleep jurors can understand it.
Even when I'm putting together a health care fraud case that also includes more complex fraud schemes, if I find evidence of billing for services with no supporting documentation, I often include those first in my summary report. During one fraud examination I conducted, an allergy doctor was providing a treatment, which was considered experimental and therefore not approved by government health care plans or other insurance companies. With a few strokes of a pen or taps on a keyboard, the allergy doctor submitted claim forms and still got paid for utilizing the experimental treatment.
She accomplished this by calling it and coding it something else that was covered by insurance plans and policies. Like most other criminals, this doctor rationalized her wrongful actions. She believed she was providing a useful service to her allergy-suffering patients and that it wasn't her fault the government and insurance companies hadn't yet approved the experimental treatment. Keep in mind that most patients are only concerned with two things: getting healthy or finding relief from their suffering and how much they personally have to pay out of their own pockets for medical services.
Because the insurance companies are footing the bills or most of them , patients usually have no qualms as long as they are regaining their health. In the allergy clinic case, the doctor only gave a few patients the experimental treatment; most received approved care. But I noticed something unusual when I reviewed the patients' files: The insurance claim forms showed that many patients were treated at the allergy clinic four or five days per week Monday through Friday.
I remember thinking, "I wouldn't come here that often even if they were giving away free lunches. Obviously, my case was getting stronger. Providers might make more money by reporting they visited with or and treated the same patient on two separate days rather than one day. Each "office visit" is usually considered a separate billable service. Often the services the fraudsters list on claim forms are actually provided, but the dates are false because it's more profitable for the providers.
So check to assure that the patients' medical file documentation matches the dates of service listed on the claim forms. Focus on the "date of service" not the date the claim form was signed or submitted because those dates may be several days after the service was provided. Let's get back to that allergy clinic.
When I interviewed patients at their homes, many who previously told me they only received injections twice a week, also told me they only went to the allergy clinic once a month. The patients said that the allergy clinic workers would hand each of them a bunch of syringes filled with antigens and tell them to inject themselves in their homes! Because I'm a bit shy of needles, and the thought of injecting myself makes me cringe, I wondered if insurance companies would knowingly approve self-injections away from the allergy clinic.
A specialist from one of the insurance companies told me that it and most other companies didn't accept self-injection as a reimbursable expense. The specialist said medical providers should monitor patients for several minutes after injections to ensure the patients don't have adverse reactions.
I examined the claim forms and found that the allergy doctor had reported that the injections were given at the allergy clinic. I started to wonder if the allergy clinic was doing anything legally. I confronted the allergy doctor with the evidence, and she claimed she didn't know this type of billing was improper.
I asked how she determined the day of the week the patients injected themselves when preparing the claim forms, and the doctor said that she just guessed. I thought it was more than a coincidence that she always "guessed" the injections were given Monday through Friday when the allergy clinic was open for business and not Saturday, Sunday or holidays when the allergy clinic was closed.
I think she knew that billing for Sunday injections would have raised red flags at the insurance companies. In other cases, I investigated physicians who had billed for services provided in their offices that were located in the U. These were closer to "no supporting documentation" fraud, but because the physicians didn't take their patients with them on their trips, those claims were really far off! It's a scary thought that somebody might impersonate a physician and bill for treatment, but it does happen.
I've conducted numerous investigations in which medical doctors signed insurance claim forms showing that they had provided all the care but in reality, lesser-educated mental health professionals actually conducted the therapy. In these cases, the affected insurance companies would still have paid for the care provided by the lesser-educated therapists as long as they were licensed , but they would have paid less.
For example, I learned that licensed clinical social workers are often reimbursed less than physicians. In another investigation, I discovered that a psychological care facility even hired people to be therapists who had never been trained to provide those services.
One of those unlicensed providers told me he was hired solely because he was a friend of the owner. The facility also had hired a part-time doctor to come in the office two days a week to review treatment files and sign claim forms.
During an interview, I asked the doctor why he had signed the claim forms when he didn't personally provide the treatment. The doctor was almost defiant when he said he was permitted to do so because he was the supervising physician.
Canadians face little government interference or oversight of their health care, although, for historical reasons, their doctors retain much more power than patients. But the system is far from perfect. Outpatient care, like physical and occupational therapy or prescription medicine, is paid for out of pocket.
And medical care of impoverished and remote First Nation and Inuit communities is openly acknowledged as abysmal. Like Americans, many Canadians with full-time jobs receive supplemental coverage as a benefit through their employers, while independent workers like David Dennis can buy a policy on their own.
Canada provides coverage for about 35 million, one-tenth the population of the United States. It can inform how U. Rather than scaring Americans with well-structured narratives about the alleged horrors of Canadian Medicare, we could take the opportunity to learn from it. Your donation keeps this site free and open for all to read. Give what you can The health care Canadians receive flows through a hybrid federal and provincial system.
Federal dollars cover roughly 20 percent of total health care costs, with each province and territory responsible for the remaining 80 percent. Poorer provinces, and those with smaller populations —like Newfoundland and Labrador , , Prince Edward Island , , and the Northwest Territories 44, —receive higher federal amounts in compensation.
The provincial ministries make decisions about how best to apply that funding, further decentralized in some provinces through regional agencies. Their fees are negotiated annually with each provincial or territorial MOH through a provincial medical association, setting specific fees for each service and specialty. The Canadian government operates mostly as insurance payers, while doctors focus on serving patients. Each doctor bills the MOH, paid in Ontario twice a month by direct deposit.
Many physicians are paid well, even for part-time work. And without multiple insurers to wrangle, Canadian doctors need fewer employees.
In contrast, I could do my billing in one hour on a Sunday evening at the computer. Nor do Canadians and their employers fear annual double-digit increases in the cost of their health insurance, which is paid for through a broad mix of taxes.
So David Dennis lives free of daily financial anxiety over potential injury, a personal and professional freedom many Americans only dream of. He plays baseball several times a week and, when he slid into second base and banged himself up badly, went to an urgent-care clinic, also covered through OHIP. Throughout his teen years, skateboarding broken left elbow , hockey broken right collarbone, separated shoulder , and baseball broken left hand sent Dennis to the local emergency room so frequently he jokes he had an E-ZPass.
More than 60 percent of its work takes place in Northern Ontario, including service to many fly-in only communities. All of this at no extra cost to patients. Broke and desperate Americans increasingly are choosing to call an Uber over an ambulance, as an ambulance ride can add the potential shock of an unaffordable four-figure bill, even with health insurance.
We'll put you in touch with the right person to answer your questions about health insurance, help you locate a doctor and provide general information. How do I know whether Loyola Medicine is part of my insurance plan? Talk to a representative of the health insurance plan.
Ask if the plan contracts with Gottlieb Memorial Hospital. If your health insurance plan requires you to use a primary care physician PCP , ask your PCP to refer you to a Loyola-affiliated provider when necessary and appropriate.
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