Don't get caught out by these medical fraud tricksters: Internet Scambusters #658
Medical fraud and other tricks to make more money at the expense of patients and insurance companies rake in more than $200 billion a year.
Sometimes, they dupe patients into becoming accomplices and, in some cases, may be endangering health.
In this week's issue, we report on 7 dubious medical-related practices and tell you how to avoid them.
Let's get started...
7 Key Medical Frauds, Misleading & Money-Making Tricks
Unscrupulous mobile labs and clinics providing diagnostic tests, dental treatment, and psychological assessments may be contributing to more than $200 billion of medical fraud in the U.S. every year.
In some cases, they dupe their "patients" into becoming unwitting accomplices in scams that target health insurers.
Or they simply charge their victims for tests and procedures they don't need and which, in some circumstances, could even be dangerous.
Before we get into the details of these scams, it's important to stress that there are many legitimate providers of these types of services. In some cases, they could be life-savers.
Just make sure you take professional advice before using them.
Here's our list of 7 key areas of medical frauds and moneymaking schemes:
1. Rolling Labs
So-called "rolling labs" turn up in the parking lots of malls, retirement homes, and churches.
These mobile labs offer diagnostic tests, often "free" or low cost, which are fairly basic but the operators get patients to sign forms that enable them to bill insurers for advanced tests.
The location actually confers some credibility. People think they're "sponsored" by whoever owns the parking lot but that usually isn't the case -- or if it is, it's because the "sponsor" has been misled.
2. Pediatric Dentistry
Mobile dental labs offer "free" treatment to kids whose parents couldn't otherwise afford it.
They may visit schools or other community facilities where kids hang out.
Again, they get authorization for their procedures and then bill Medicaid.
Many of these services are perfectly legitimate but some experts have questioned the amount of treatment they provide and whether all of these procedures are really necessary.
In other cases, they may bill for treatment they haven't carried out at all.
3. Mental Health Centers
Questionable "mental health centers" are popping up around the country providing non-standard and sometimes worthless assessments or other services.
Oftentimes, they're seen as exploiting growing concerns about dementia, but they actually don't have the facilities or professional expertise to conduct meaningful tests.
In reality, they may be just respite centers where people with mental health issues can meet or socialize.
They may be legitimate, but using the "mental health center" label gives the wrong impression about what they do.
Users may be charged directly or insurers may be billed.
4. Runners and Cappers
Runners and cappers are the terms used in the insurance and medical scams world for anyone who goes around drumming up business for the fraudsters.
They may simply travel around neighborhoods knocking on doors inviting people to visit rolling labs or medical clinics for needless or non-existent tests.
They may also use telesales calls and high-pressure tactics to tout for business.
The terms are also used for crooks that organize staged car crashes in which "victims" (who actually know what's going on) seek treatment from doctors and clinics that are in on the scam.
5. High Volume Testing
This is the questionable practice of providing diagnostic tests for people who don't really need them or who don't know of the dangers involved in some procedures like X-rays and MRI scans.
Referring professionals may receive a commission for sending patients for treatment, while diagnostic services may be looking to increase the volume of business to offset what they see as the low fees paid by Medicare.
Research suggests up to one third of radiology tests are unnecessary and, according to Consumer Reports: "(T)he more radiation people are exposed to, the greater their lifetime risk of cancer."
6. "Free" Equipment
This long-standing scam switches focus from one product to another over a period of time.
Past practices include so-called home alert systems, which are promoted as being free when they actually come with a monthly monitoring charge.
Most recently, door-to-door sales people have been offering free or low-cost "arthritis kits," which turn out to be nothing more than what you could buy over the counter at a local drug store.
But the crooks obtain customer signatures and then bill insurers for advanced equipment that would cost up to $3,000.
7. Compensation Claims
Runners (see above) and telesales callers have been calling people and asking them if they've ever been involved in recent medical or surgical practices that, elsewhere, have led to lawsuits.
If they have, the caller offers to pursue a compensation claim in return for either a cut of the money or for a fee that must be paid in advance.
This practice is dubious to say the least. But if the person hasn't been involved in these malpractices, a scammer may then offer them money to say they have, so a fraudulent claim can be made.
What to Do
You can avoid the risk of falling victim to these scams, scammers, and dubious practitioners by taking the following steps.
- Speak to your trusted healthcare professional before having any diagnostic tests, whether at a rolling lab or anywhere else.
- Even when your doctor is recommending a test, ask them to explain why it is necessary.
- Check out this AARP list of medical tests to avoid.
- As AARP recommends, visit http://www.choosingwisely.org -- a site set up by the American Board of Internal Medicine to help the public understand more about tests.
- Don't accept "free" medical equipment or services via door-to-door or telesales solicitations, no matter who the caller says they represent.
- Don't sign blank Medicare or health insurance claim forms that others present to you, or give an open authorization for them to bill for services they provide.
- Check out the credentials of any organization offering "free" medical or dental care and understand exactly what procedures they plan to carry out. Ask for treatment details in writing.
- Again, talk to a professional before attending a facility supposedly offering mental health care.
- When you have to pay for a service you're not familiar with, make sure you know how much you have to pay and what you're paying for.
- Never participate in any activity you suspect may be part of an attempt to defraud an insurer.
Remember, your health is your life. It's too precious to put at risk of medical fraud.
Alert of the Week
We've seen them on other social media networks, now scams that promise prizes in return for following and sharing are appearing on the photo-sharing service Instagram.
Almost certainly, prize and gift offers like this are fake. But if you need confirmation, check out the supposed offer by doing an online search using the name of the site and words like "scam" and "fake."
Time to conclude for today -- have a great week!