From Capital Blue Cross
Photo courtesy of Nappy on Unsplash
The arrests of 11 individuals in connection with an alleged $10 billion Medicare fraud case serves as an important reminder to review your insurance statements and guard your personal information.
This case is not an isolated incident – healthcare fraud costs the U.S. billions every year. Capital Blue Cross has seen an uptick in fraudulent claims involving durable medical equipment (DME) like diabetic supplies, urinary catheters, and knee braces, said Chief Medical Officer Dr. Jeremy Wigginton.
Technology and an aging population are making it easier for scammers to exploit Medicare, and the scale and sophistication of these schemes highlight just how important it is to be on the lookout.
“They talk the language, they know medical lingo, and they’re very persistent,” Dr. Wigginton said. “Once they have your information, they can submit false claims for services or equipment that were never provided or needed.”
Tips to Protect Yourself Against Health Insurance Scams
Capital Blue Cross has a dedicated team that works with local, state, and federal law enforcement to detect, report, and prevent healthcare fraud. Their work has identified millions of dollars in fraudulent claims.
Dr. Wigginton said preventing these scams takes everyone’s help. Here are tips to avoid scams:
- Protect your information: Never give out your personal information, such as birth date, social security numbers, Medicare number, or health insurance number.
- Ignore unsolicited offers: If you are unsure whether a caller is legitimate, ask for the person’s phone number and tell them you will call back.
- Verify with your doctor: Ensure any durable medical equipment (DME) is prescribed by a doctor who has personally assessed your condition. If you are offered medical equipment or services you did not ask for or do not need, decline the offer.
- Avoid suspicious links: Scammers often send emails or texts that look official, like they’re from Medicare or Capital Blue Cross. If you don’t recognize the source or the message looks suspicious, don’t click the link.
- Check insurance statements: Monitor your Medicare statement and your explanation of benefits (EOB) from Capital Blue Cross for services that you never received.
If you receive unrequested medical equipment or suspect fraudulent activity, report it right away. Visit the Capital Blue Cross website to learn various ways to report suspicious activity.
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Source: bctv