Medicare Fraud

Don M.

Don M.

SF VIP
Location
central Missouri
One of the old neighbors dropped by this evening, and asked me to take a look at a statement he received from Medicare. According to the statement, his wife had a procedure at the hospital back in early February, and Medicare covered all the costs. The only problem is...his wife passed away last Fall. I went to the Web and found the 800 number he needs to call to report this to Medicare.

Medicare Fraud is a problem that costs us All. There are billions of dollars of bogus charges sent to Medicare/Medicaid and the insurance companies each year by unscrupulous doctors and hospitals, and we All need to review and question any charges that appear to be "incorrect".
 

I think a lot of hospital billing departments pressure staff to do anything and everything to get paid and/or show proof they at least billed someone. I know people in an auto accident with good auto insurance but the hospital didn't want to wait and billed medicare right away(auto insurance info was in towed away car, got information to them less than 24 hours later). So now the taxpayers are on the hook for what a private company should've paid for and a private hospital should've waited for. The patient doesn't want to force the issue since their bills were paid.
 
Last edited:
WhatInThe said:
I think a lot of hospital billing departments pressure staff to do anything and everything to get paid and/or show proof they at least billed someone. I know people in an auto accident with good auto insurance but the hospital didn't want to wait and billed medicare right away(auto insurance info was in towed away car, got information to the less than 24 hours later). So now the taxpayers are on the hook for what a private company should paid for and a private hospital should've waited for. The patient doesn't want to force the issue since their bills were paid.
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Yup, but when a hospital bills Medicare for treatment of a person who has been dead for 6 months, there is obviously something wrong.
 

Hopefully no bills for any co pays or deductibles start rolling in. Medical insurance theft or patient ID theft has been growing for a decade now. I would pursue ID theft charges see where it lands. Is it an "error" or is it straight up theft/criminal activity. Although many consider hospital billing practices criminal.
 
It's a huge problem in Canadian border towns. People from the USA were borrowing Canadian citizen's cards to get free treatment at clinics. They started cracking down now with picture ID cards. But there is still fraud.

The other fraud going on is that drinking in the USA is 21 years and in Canada 19 years. Saturday night fights are common in the bars and USA citizens are hospital treated and released with a promise to pay. Does not happen often.
 
Back in 1992 my dad's summary of medicare charges included a hysterectomy. He contested it and asked for a hearing. Turns the lady who got the hysterectomy is named Frances (last name). Dad's name is Francis (same last name). The problem was a hospital billing error.

He got a quick response when he called to complain. Hearing was set within 3 months time, problem resolved that day.

'course, no one argued that he had gotten a hysterectomy.
 

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