Health Insurance Fraud: What You Should Know

Health insurance fraud represents one of America’s largest taxpayer rip-offs ever, costing Americans literally billions of dollars every year.Due to rampant deception, scams and abuse in the health care system, consumers are forced to pay the price–literally–through escalating medical costs and rising health insurance premiums.And government programs like Medicare and Medicaid, designed to help the low-income and elderly, represent two of the biggest losers of all.Health Insurance ScamsAccording to the Insurance Information Institute, health providers and facilities such as doctors, hospitals, nursing homes, diagnostic labs and attorneys routinely attempt to defraud the health insurance system…with devastating results.How do they do it? In a number of ways, including:
Billing health insurance companies for expensive treatments, tests or equipment patients never had or never received
Double- or triple-billing health insurers for the same treatments
Giving health care recipients unnecessary, dangerous, or life-threatening treatments
Selling low-cost health insurance coverage from fake insurance companies
Stealing medical information and using it to bill health insurance companies for phantom treatments
If health insurance fraud knocks on your door, these types of scams may leave you with medical debts, damaged credit ratings, falsified health records, a high level of stress and overpriced health insurance premiums…or the inability to get any health insurance at all.So what can you do about it?Report it; then fight back!What to Watch ForThe first step to fighting health insurance fraud is keeping your eyes and ears open for abuse.Be especially watchful for providers who:
Charge your health insurance company for services you never received or medical procedures you don’t need
Give you prescriptions for controlled substances for no justified medical reason
Bill your health insurance company for brand-name drugs when you actually get generics
Misrepresent cosmetic or other health care procedures not usually covered by health insurance plans as covered
If you notice a health care provider doing any of these things, keep all supporting paperwork handy for reference, and then contact your health insurance company to let them know.Then, if you’re a Medicare or Medicaid recipient, call the U. S. Department of Health and Human Services and report the abuse.Finally, contact your state department of insurance or the local police.Fighting Health Insurance FraudTo keep yourself from falling victim to health insurance fraud, take the following steps to fight back:* Check with your state insurance department to make sure your health insurance company is licensed in your state.* Check out your health insurance company for consumer complaints, fraud convictions and bankruptcies through your state department of insurance.* Keep detailed medical records.* Carefully review your billing statements.* Never sign blank insurance claim forms.* Avoid salespeople offering free health services or advice.* Protect your medical records and information.* Make sure you know what your health insurance policy covers–and what it doesn’t.* Never pay your health insurance premiums in cash.* Be wary if you’re asked to pay a full year’s premium up front.* Be on guard against medical providers claiming to be connected with federal programs or the government.* Beware of health insurance companies offering you coverage at an unreasonably low price.* Ask your health insurance provider about anything you don’t understand regarding your bills.Making a DifferenceProtect your right to health insurance, lower your premiums and keep your medical information safe. All it takes is a little education, a watchful eye, and the willingness to make a difference!

Personal Health Information – Keeping Tabs On Your Health In Texas

Your personal health information — do you know who has it or where to find it in Dallas, Houston or in the other Texas cities where you have lived? Do you have it? In most cases, a complete record of all of your personal health information can’t be found at any single location or in any consistent format. Each one of your healthcare providers (family practitioner, allergist, OB-GYN, etc.) compiles a separate medical record on you. And often times, these multiple medical records can lead to an incomplete story about your health.Keeping your own personal health record (PHR) provides doctors with valuable information that can help improve the quality of care you receive. A PHR can minimize or eliminate duplicate tests. It can also help you receive faster, safer treatment and care in an emergency. In short, with a PHR, you can play a more active role in your healthcare.Starting a Personal Health RecordYour health information is scattered across many different providers and facilities. A Personal Health Record is a collection of this information about your health or the health of someone you are caring for, such as a parent or child that you would actively maintain and update. The information comes from your healthcare providers, and most importantly, from you.Why Start a PHR?Your own PHR should provide a different perspective, showing all your health-related information. It can include any information that you think might affect your health, including information that your doctor may not have, such as your exercise routines, dietary habits, or glucose levels if you are diabetic.In addition, the PHR is a critical tool that enables you to partner with your providers. It can reduce or eliminate duplicate procedures or processes, which can save healthcare dollars, as well as your time and the provider’s time.What Should be in Your PHR?When collecting information from your health records, make sure you include:* Personal identification, including names, birth dates, and social security numbers* Emergency contacts* Names, addresses, and phone numbers of your physician, dentist, and other specialists* Health insurance information* Living wills and advance directives* Organ donor authorization* A list and dates of significant illnesses and surgeries* Current medications and dosages* Immunizations and their dates* Allergies* Important events, dates, and hereditary conditions in your family history* A recent physical examination* Opinions of specialists* Important tests results* Eye and dental records* Correspondence between you and your provider(s)* Correspondence between you and your health insurance company* Permission forms for release of information, operations, and other medical procedures* Any information you want to include about your health – such as your exercise regimen, any herbal medications you take and any counseling you may receive.Step-by-Step Guide to Creating a PHRYoung, healthy people move, often frequently. Therefore you are likely to have health records scattered over all over Texas and beyond. Remember the flu last year in Dallas? And the routine exam three years ago in Houston? Keeping your own personal health record (PHR) provides new and existing doctors with valuable information that can help improve the quality of care you receive.To start your personal health record, you will need to request a copy of your health records from all your healthcare providers, including your general practitioner, and your eye doctor, dentist, and any other specialists you have seen. Don’t feel that you need to gather all your health information at the same time. One way to handle your record retrieval is to ask for your recent records each time you visit a healthcare provider.Incorporate the following steps, at your own pace, when creating your own personal health record:1. Contact your doctors’ offices, the health information management (HIM) or the medical records staff at each facility where you have received treatment. Ask if your records are in an electronic format that you can access, or if you need to request copies. Also, ask your physician or the HIM professional to help you determine which parts of your record you need. Furthermore, find out if your provider has his or her own plan for helping patients to create their PHRs.2. Ask for an “authorization for the release of information” form. Complete the form and return it to the facility as directed. Most facilities charge for copies. The fee should only include the cost of copying (including supplies and labor), as well as postage if you request the copy to be mailed. It can take up to 60 days to receive your medical records, so ask when you can expect to receive the information you’ve requested.3. Now that you’ve gathered your information, there are a few different ways you can maintain your PHR. One way is to simply gather your information in a file folder. Not all information may be available to you in an electronic format, so an old-fashioned file folder or three-ring binder may be the easiest and most inclusive format. You can divide the binder into sections by family members. Then, within each family member’s section, divide information by year or illness.4. There are many great digital PHR tools and services to help you get organized. You can burn data onto a CD. Also, portable devices, like keychain USB drives that plug into most computers, will make your PHR information extremely portable. There are also Internet-based services where you can store and retrieve your health information, including services which may be sponsored by your insurance company. Some services even help collect your data from your doctors and other healthcare providers.Some of these digital PHR tools may be available free of charge and others are products or services you will need to purchase or pay a subscription fee to use.5. Bring your PHR to all healthcare provider visits so that you have the information with you. And remember to keep adding and updating it with entries from providers, yourself, or your family member.6. Because you won’t always have your PHR with you, create and carry a card that has vital information on it—such as medications or allergies—with you at all times.7. Remember, this private information is yours and your family’s, so protect it and maintain its confidentiality. Let trusted family members know it exists, and where it’s being kept, but beyond that, keep it safe and protected.Knowledge is power and your Personal Health Record can certainly empower you. The information gathered gives you information you can use when preparing for medical appointments. And it gives you more intimate knowledge of your healthcare, including giving you an active role in your preventive care and care management.It’s easier to start gathering your medical records while you’re a young, healthy Texan compared to when you’re older and have a more complex medical history. Start with your parents and work your way up to your current healthcare providers.With your PHR in hand, you will then want insurance to help with the costs when you need to visit physicians or have an unexpected hospitalization. Why not take a look at the revolutionary comprehensive individual health insurance solutions created by Precedent specifically for young, healthy individuals? Precedent offers affordable, individual health plans,. For more information, visit us at our website, []. We offer a unique and innovative suite of individual health insurance solutions, including highly competitive HSA-qualified plans, and an unparalleled “real time” application and acceptance experience.

Health Screenings Provide Health and Financial Benefits to Businesses

Corporate health screenings are a growing trend for companies seeking ways to reduce expenditures and provide a better quality of health for employees. By encouraging and maintaining the wellness of workers, the possibility of preventing potential health problems increases, which can result in lowering medicals costs associated with treating a condition in its advanced stage. Implementing preventive health care programs that include regular health screenings, immunizations and education is the first line of defense against health problems and rising health expenditures for businesses.Chronic illnesses and health conditions can decrease employee productivity and increase absenteeism and presenteeism, which greatly impacts a company’s bottom line. In fact, The Human Resources Policy Association puts the annual cost of reduced productivity for businesses between $87 and $127 billion. Diabetes, high blood pressure, heart disease, high cholesterol and complications from obesity are listed by The Center for Disease Control as illnesses most commonly uncovered during health screenings. If undetected and left untreated, problems resulting from these conditions can disrupt every aspect of an employee’s life, including productivity in the workplace.”Preventive health care is an efficient and effective method of identifying and treating possible health conditions before they have the opportunity to develop or worsen,” says Dr. Jeffrey Greiff, founder of Flu Busters, a third-party provider of on-site preventive health care for businesses. “When a potential health condition is diagnosed in its early stages, it can be easily remedied and can prevent more serious conditions, resulting in a much healthier patient over time.”An Employer Health Benefits Survey found from 2002 to 2007, health insurance premiums for businesses increased approximately five times faster than inflation and four times faster than wage growth. As health insurance premiums continue to increase throughout the 2008 – 2009 fiscal year, analysts believe health care costs are a threat to the financial success of American businesses. Businesses are discovering the economic benefits of preventing and identifying employee health problems before they become serious ailments by offering annual on-site health screenings that improve and protect employees’ current and future state of health.A common deterrent for employees against receiving health screenings and immunization by a primary care physician is that the medical services can interrupt an employee’s busy day resulting in wasted time and energy. Third-party health care providers are gaining popularity in the business world due to their ability to provide on-site services to companies of any size. So, how does it work?Health screenings are available to companies of all sizes and can be provided on-site by a team of experienced health professionals. Prior to a health screening, information sheets are provided to make recommendations on what screenings would be most beneficial for an employee based on individual circumstances, such as, age, sex and family history. The actual screening takes only minutes and employees receive most screening results within minutes of the actual screening. A post-screening consultation with a registered health professional, as well as an online customized wellness program is offered to address any existing or potential health issues that may have been uncovered in the screening. From the initial screening to the post-screening consultation phase, the screening participants are actively assisted in developing solutions that will enable them to lead healthier, more productive and fulfilling lives.Even through economic hardships, businesses can still provide employees with quality health care by focusing on prevention. Routine health screenings and immunizations can identify and prevent illnesses, resulting in healthier employees, lower insurance premiums, increased productivity and decreased absenteeism. Businesses that establish a comprehensive wellness plan are investing in their employees, and ultimately, the company’s success.